EU disease expert sees “super superbug” spread

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A multi-drug resistant “superbug” from India first reported in Britain in August has now been detected in 12 more countries, a scientist at the EU’s disease control watchdog said.

Dominique Monnet of the European Center for Disease Prevention and Control said he was very worried by the emergence of NDM-1, or New Delhi metallo-beta-lactamase, and other bugs like it that are resistant to even the most powerful class of antibiotics, known as carbapenems.
“I know people are calling this NDM-1 a superbug, but for me NDM-1 and bacteria like it are more than superbugs. We’re talking about super superbugs,” Monnet said in a telephone interview from Stockholm, where the ECDC is based, Reuters reports.
“For a long time … doctors in hospitals, especially in intensive care units, have relied on the carbapenems as the last line of antibiotic treatment. Now, for doctors facing a patient infected with a bacteria that is resistant to carbapenems, the options for treatment are limited.”

British researchers reported in August that the new NDM-1 superbug had been found in patients in South Asia and in Britain and said they feared it could swiftly spread around the world, in part because of international travel and medical tourism.

U.S. health officials said at the same time that three cases had been detected in the United States.

Monnet is due to publish a research paper later this week in the online journal Eurosurveillance which shows how the bug is spreading in Europe.
“There are now 12 countries other than the UK that have reported cases of NDM-1,” he said. “From the data that we have compiled, the first cases are from 2008 and there is an increasing number of reported cases from 2008 to 2009 to 2010.”

Almost as soon penicillin, the world’s first antibiotic, was introduced in the 1940s, bacteria began to develop resistance to its effects, prompting scientists and drug company researchers to work on developing many new generations of antibiotics.

Experts say their constant overuse and misuse have fueled the rise of drug-resistant superbug infections such as Clostridium difficile, or methicillin-resistant Staphyloccus aureus (MRSA).

Now carbapenems — a class of the drugs traditionally reserved for emergency use and to treat infections caused by the likes of MRSA and C-difficile — are also becoming powerless in the face of ever more ingenious bacteria.
“Doctors have relied very much on the availability of new antibiotics,” Monnet said. “They have always had this kind of forward escape strategy of counting on the pharmaceutical industry to produce new antibiotics that will help counteract the emergence of resistance.”
“But what we have now is increasing multidrug resistant bacteria in the EU and at the same time a rather dry pipeline for new antibiotics.”

A few large drugmakers, including Pfizer, Merck, AstraZeneca, GlaxoSmithKline and Novartis, are hunting for new antibiotics but the scientific difficulty and expense of finding effective treatments is stacked against the limited sales potential of drugs that are typically reserved for the sickest patients.

Experts cite only two drugs that can stand up to carbapenem-resistant infections.



One is colistin, an older antibiotic which Monnet said has such toxic side effects that it would probably not be approved for a license under today’s drug regulation standards. The other is Pfizer’s antibiotic Tygacil, known generically as tigecycline, which Monnet said only works in some cases.