Yesterday and today are early-publication days for the December issue of Emerging Infectious Diseases, the free peer-reviewed journal published by the Centers for Disease Control and Prevention. (Are you reading it? Why not? Your tax dollars pay for it. Go, now.) Among many interesting stories — more on those in later posts — there are two important, complex and saddening papers updating the relentless spread of the “Indian supergene,” New Delhi metallo-beta-lactamase or NDM-1.
(Pause for commentary: I hope we’ve put to rest by now the canard that naming this gene after New Delhi indicates some secret agenda to inflict stigma on the subcontinent’s burgeoning medical-tourism industry. It is a long-standing convention that the acquired metallo-beta-lactamases are named for their point of origin: Holland, Singapore, Germany, et al. You don’t see Vienna complaining, do you? ‘Nuf said.)
A brief recap, for those who spent August focused on something more interesting that bacterial resistance: NDM-1 is a gene that produces an enzyme that confers resistance on gram-negative bacteria to almost all the drugs used to treat them. The American Type Culture Collection, which sells isolates for research, recently published the table of resistance results, and it’s phenomenal: All Rs, all the way down. It was first identified in 2008 in a native of India, resident in Sweden, who had been hospitalized while on a visit back home; then found in the UK in 2009; and then found in the US in June this year. It renders bacteria that are common causes of hospital-acquired infections — Klebsiella, Acinetobacter, E. coli — resistant to all but one or two drugs. It’s extremely bad news. (My NDM-1 posts are here.)
It’s been clear since 2009 that NDM-1 is spreading around the world with great speed. The newest papers in EID confirm that and fill in the details — and wow, some of them are so sad.