New drug-resistant superbugs
found in 3 states
BOSTON (AP) An infectious-disease nightmare is unfolding: A
new gene that can turn many types of bacteria into superbugs
resistant to nearly all antibiotics has sickened people in three
states and is popping up all over the world, health officials
The U.S. cases and two others in Canada all involve people who
had recently received medical care in India, where the problem
is widespread. A British medical journal revealed the risk last
month in an article describing dozens of cases in Britain in
people who had gone to India for medical procedures.
How many deaths the gene may have caused is unknown; there is no
central tracking of such cases. So far, the gene has mostly been
found in bacteria that cause gut or urinary infections.
Scientists have long feared this a very adaptable gene that
hitches onto many types of common germs and confers broad drug
"It's a great concern," because drug resistance has been rising
and few new antibiotics are in development, said Dr. M. Lindsay
Grayson, director of infectious diseases at the University of
Melbourne in Australia. "It's just a matter of time" until the
gene spreads more widely person-to-person, he said.
Grayson heads an American Society for Microbiology conference in
Boston, which was buzzing with reports of the gene, called NDM-1
and named for New Delhi.
The U.S. cases occurred this year in people from California,
Massachusetts and Illinois, said Brandi Limbago, a lab chief at
the Centers for Disease Control and Prevention. Three types of
bacteria were involved, and three different mechanisms let the
gene become part of them.
"We want physicians to look for it," especially in patients who
have traveled recently to India or Pakistan, she said.
What can people do?
Don't add to the drug resistance problem, experts say. Don't
pressure your doctors for antibiotics if they say they aren't
needed, use the ones you are given properly, and try to avoid
infections by washing your hands.
The gene can spread hand-to-mouth, which makes good hygiene very
It's also why health officials are so concerned about where the
threat is coming from, said Dr. Patrice Nordmann, a microbiology
professor at South-Paris Medical School. India is an
overpopulated country that overuses antibiotics and has
widespread diarrheal disease and many people without clean
"The ingredients are there" for widespread transmission, he
said. "It's going to spread by plane all over the world."
The U.S. patients were not related. The California woman needed
hospital care after being in a car accident in India. The
Illinois man had pre-existing medical problems and a urinary
catheter, and is thought to have contracted an infection with
the gene while traveling in India. The case from Massachusetts
involved a woman from India who had surgery and chemotherapy for
cancer there and then traveled to the U.S.
Lab tests showed their germs were not killed by the types of
drugs normally used to treat drug-resistant infections,
including "the last-resort class of antibiotics that physicians
go to," Limbago said.
She did not know how the three patients were treated, but all
Doctors have tried treating some of these cases with
combinations of antibiotics, hoping that will be more effective
than individual ones are. Some have resorted to using polymyxins
antibiotics used in the 1950s and '60s that were unpopular
because they can harm the kidneys.
The two Canadian cases were treated with a combination of
antibiotics, said Dr. Johann Pitout of the University of Calgary
in Alberta, Canada. One case was in Alberta, the other in
Both patients had medical emergencies while traveling in India.
They developed urinary infections that were discovered to have
the resistance gene once they returned home to Canada, Pitout
The CDC advises any hospitals that find such cases to put the
patient in medical isolation, check the patient's close contacts
for possible infection, and look for more infections in the
Any case "should raise an alarm," Limbago said.