In Indian hospitals, over 50% of bacterial infections are now resistant to commonly used antibiotics. Surveys have shown that many widespread pathogens in India are also resistant to powerful, broad-spectrum antibiotics. In 2010, a team of scientists analyzed bacterial infections in New Delhi and found that 24% could resist the hospital’s last resort intravenous antibiotics, carbapenems, and 13% had a super-resistant gene, New Delhi metallo-ß-lactamase 1 (NDM-1), that conferred resistance to carbapenems and 14 other antibiotics.
Since then, NDM-1 bacteria have been found in drinking water supplies, in puddles, and in patients in over 35 different countries. Of the infected patients, many are medical tourists, having traveled from Europe, the Middle East, and the Americas to India and Pakistan for inexpensive medical care.
New drugs have been in development to treat microbes with the NDM-1 gene. In the West, gram-positive bacteria, which are structurally vulnerable to antibiotics and disinfectants, are most common while in India and other tropical countries, there tend to be gram-negative bacteria, which have a tougher outer membrane that can repel antibiotics. Since most of the pharmacological industry develops drugs for the Western markets, India is vulnerable to an epidemic.
Antibiotic use is unchecked, so the drugs themselves are overused, which is one of the causes of drug-resistant bacteria. Patients do not need a prescription to get antibiotics.
There is also a political component in this, as when the gene was first discovered in Europe in patients who had traveled to India for medical care, it was named after the city from which it seemed to originate, which caused a furor.
For now, NDM-1 bacteria need to gain more notoriety so that the state will do something before there is an outbreak.