Drug resistant superbug could hit Portugal

By PAULO SILVESTRE [email protected]

A new threat to public health, a superbug that is resistant to antibiotics, is causing alarm among health authorities across Europe.

The infection, which originated in India, is slowly spreading and has already caused one death in Belgium.

Known as the New Delhi Metallo-beta-lactamase (NDM-1), this enzyme makes bacteria resistant to a broad range of beta-lactam antibiotics.

This includes antibiotics of the carbapenem family, which are a mainstay for the treatment of antibiotic-resistant bacteria.

The gene for NDM-1 is one member of a large gene family that encodes beta-lactamase enzymes called carbapenemases.

Bacteria which carry such genes are often referred to as superbugs, since infections with these bacteria are very hard to treat successfully.

According to the Portuguese General Directorate of Health (DGS), the NDM-1 bacterium has not been detected in the country and all procedures are being taken to prevent cases here.

General Director of Health, Francisco George, said: “Active monitoring has to be carried out, especially in hospitals with patients from India and other countries where there are already cases reported.”

The director for the Centre of Medicine Based Evidence, António Vaz Carneiro, added: “This bacterium is highly aggressive and resistant

to antibiotics. It is natural that bacteria and

viruses alter their genetic code and gain immunity, so the drugs are not

effective. It is necessary to take all kinds of prevention such as washing hands regularly.”

The European Centre for Disease Prevention and Control (ECDC) is alert to the threat of this superbug and says it is monitoring the situation closely with the national institutes of health of several countries in Europe.

According to the ECDC, this new enzyme was detected in 2008 in Swedish patients treated in New Delhi, India.

There followed other cases of infection in tourists who travelled to India or Pakistan.

The ECDC states on its website that “it is monitoring the situation closely in cooperation with national public health institutes across Europe. It has initiated a risk assessment on the spread of carbapenemase-producing Enterobacteriaceae (including KPC-, NDM-1- and other metallo-lactamase-producing strains) through patient transfer between healthcare facilities, with special emphasis on cross-border transfer. This risk assessment should be completed by the end of 2010.”

Currently, there are dozens of cases of infection confirmed in 11 countries.