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Gene Makes 'Superbugs' Resistant to Drugs

Some bacteria in south Asia have learned a new way to deactivate the antibiotics that usually kill them, according to a new study, raising concerns about a novel wave of drug-resistant "superbugs" that travelers could spread world-wide.

The study, published Tuesday in the journal Lancet Infectious Diseases, found the presence of a new gene called NDM-1 that gives certain kinds of bacteria the ability to produce a chemical that renders many antibiotics useless. The newly equipped superbugs were found in 180 patient samples from Pakistan and India, as well as in the U.K. in samples from patients who had had surgery in India. The study included researchers from universities and medical centers in the U.K., India, Pakistan and Australia.

In the first six months of this year, NDM-1 cases were identified in the U.S. for the first time, according to the U.S. Centers for Disease Control and Prevention. All three of the patients had received recent medical care in India.

Public health officials have been concerned about superbugs, particularly one type prevalent in hospitals known as methicillin-resistant Staphylococcus aureus, or MRSA, because they can kill patients.

Between 1999 and 2005, some 278,203 patients in the U.S. were hospitalized for MRSA-related infections, according to national data on hospital discharges. The indiscriminate use of antibiotics has been blamed as the main factor responsible for the rise of antibiotic-resistant bacteria.

The emergence of antibiotic-resistant bacteria is common, but raises concerns when the new superbugs cause disease, according to Victor Nizet, a professor of pediatrics and pharmacy at the University of California, San Diego, who does research on bacterial infections. He wasn't involved with the study.

Infection by bugs with this new gene doesn't seem to be deadly for patients, but can cause urinary-tract infections and could be serious for those who have already been weakened by surgery or are particularly young or elderly. Moreover, the infections could be difficult to treat because they would be resistant to the most commonly used antibiotics, according to Dr. Nizet.

The NDM-1 gene is found in bacteria that normally live in the gut, such as E. coli, which come from a different family than MRSA. The gene can easily jump to other bacteria in the digestive tract, said Dr. Nizet. With the gene, the bacteria can render useless the entire family of antibiotics that includes penicillin and related synthetic antibiotics.

It's unclear how common these bugs are, what the likelihood is of contracting this type of infection from hospitals in the countries in which it has been found, or how easily the bugs could be transmitted across countries by travelers, said Johann Pitout, a University of Calgary medical microbiologist who wrote an editorial accompanying the study.

"The take-home is that iIf you're traveling to India and get admitted to the hospital, then come [home] and are admitted there," you should tell health-care workers about your previous hospital experience, said Dr. Pitout.

A spokeswoman for the U.K.'s Health Protection Agency said 50 cases of the new bug were reported in the U.K. between 2007 and 2009. How many of those were fatal is unknown. So far, most of the cases are in people returning from India and Pakistan, she said. There aren't yet signs that the bug is spreading inside the U.K., though the fact that the bug is widespread in India is a cause of concern, she said.

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