NEW DELHI // Indian officials have admitted for the first time the presence of an antibiotic-resistant "superbug" in Delhi hospitals, despite claims from some politicians that it was a conspiracy by foreign scientists to undermine the nation's medical tourism industry.
The health minister of Delhi state, AK Walia, confirmed the presence of the NDM-1 gene, which makes bacteria resistant to almost all antibiotics, in several of the capital's leading hospitals, although he said the prevalence rate was "not alarming" and NDM-1 had not been found in the city's water and sewage lines.
"The infection rate is very low - between 0.04% and 0.08%," he said yesterday. "We are putting in place guidelines and monitoring systems to ensure this is kept under control."
However, a British scientist who has co-authored two controversial reports into NDM-1 said yesterday that the Indian government was still underestimating the threat, and that between 100 and 200 million Indians could already be carrying the gene.
"NDM-1 is no longer a hospital infection control problem, but has now become a public health catastrophe," said Prof Timothy Walsh, of Cardiff University in an interview with the Times of India.
The gene makes bacteria resistant to antibiotics, including a group called carbapenems, which are known as antibiotics of last resort. In some cases, infections with NDM-1 positive bacteria have been completely untreatable.
Prof Walsh's study in British medical journal The Lancet in August 2010 found that cases of NDM-1 in the UK were often people who had recently been admitted to hospitals in India and Pakistan.
The team followed up with a report in April that found evidence of NDM-1 positive bacteria in Delhi's water supply. He said that poor sanitation, the overuse of antibiotics and a lack of infection control procedures, particularly in public hospitals, are responsible for its spread.
The gene was first identified in a Swedish patient admitted to a hospital in India in 2008. In line with standard practice, it was named New Delhi metallo-beta-lactamase 1, after the city in which it was believed to have originated.
The name remains a sore point with India's health authorities.
"When New Delhi was included in the name, we definitely felt that this was linked to India's growth as a centre for medical tourism," said Dr Walia. "Dragging the name of our city into this has given the country a bad name."
Thousands of Westerners travel to India for medical treatment every year, seeking cheaper and faster services than they can receive back home, particularly for cosmetic surgery. India has even introduced a special visa category to cater for the growing number of medical tourists.
One member of parliament, SS Ahluwalia, described last August's Lancet study as "a sinister design of multinational companies."
Prof Walsh said his team has received close to 60 abusive emails and that the government has hindered attempts to access bacterial samples from Indian hospitals.
"I cannot say whether the Indian government is finally taking the issue seriously— only they can answer that charge," he said.
"What is clear is that we have lost a year fighting amongst ourselves when our energies and resources should have been focused elsewhere — on NDM-1 positive bacteria."
In fact, Prof Walsh's team was not the first to write a paper on NDM-1. That credit goes to a team at PD Hinduja National Hospital and Medical Research Centre in Mumbai, who published a study in March 2010 showing 22 cases of NDM-1 at their hospital in a three-month period, which they described as "a worrisome trend."
One of the authors, Dr Camilla Rodrigues said the hospital has been able to limit further infections but said the process of extreme isolation for suspected cases was "hugely expensive".
Nonetheless, she said she was surprised by the controversy NDM-1 had caused.
"Growing resistance to antibiotics has been a trend the world over for the past 40 years," she said. "The more you use them, the more you lose them."
