Discussion:
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
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navanavonmilita
2010-08-13 18:03:58 UTC
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India is SHIT-Scared About New Delhi Metallo-1: Sid Harth

Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News

12:22 pm

August 13, 2010

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by Scott Neuman

Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.

The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.

Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.


Bombay News.Net quoted Azad as saying:

It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
quoted S.S. Ahluwalia saying:

It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."

India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.

Comments


Recent First Oldest First Most Recommended m Reddy (mtr) wrote:

I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.

this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM

Recommend (0)
Report abuse

A Mahmud (Aboo) wrote:

Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM


Recommend (1)
Report abuse

...and I am Sid Harth
navanavonmilita
2010-08-13 18:21:41 UTC
Permalink
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
E-mail
Share
Print
Comments (2)
Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase

From Wikipedia, the free encyclopedia

ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]

The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.


Function

Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]

The following antibiotics are inactivated by the enzyme:

cephalosporins
penicillins
carbapenem

The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.

Origin and spread

The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]

In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that it
was susceptible to tigecycline and colistin.

As of June 2010, there were three reported cases of Enterobacteriaceae
isolates bearing this newly described resistance mechanism in the US,
the CDC stated that "All three U.S. isolates were from patients who
received recent medical care in India."[8] However, US experts have
stated that it is unclear if this strain is any more dangerous than
existing antibiotic-resistant bacteria such as methicillin-resistant
Staphylococcus aureus, which are already common in the USA.[9]

In July 2010 a team in New Deli reported a cluster of three cases of
Acinetobacter baumannii bearing NDM-1 that were found in the intensive
care unit of a hospital in Chennai, India in April 2010. As
previously, the bacteria were fully resistant to all the
aminoglycoside β-lactam and quinolone antibiotics, but were
susceptible to tigecycline and colistin. The broad spectrum of
antibiotic resistance was due to the strain bearing several different
resistance genes in addition to NDM-1.[10]

A study by a multi-national team was published in the August 2010
issue of the journal The Lancet Infectious Diseases. This examined the
emergence and spread of bacteria carrying the NDM-1 gene. This
reported on 37 cases in the United Kingdom, 44 isolates with NDM-1 in
Chennai, 26 in Haryana and 73 in various other sites in Pakistan and
India.[1] The authors' analysis of the strains showed that many
carried NDM-1 on plasmids, which will allow the gene to be readily
transferred between different strains of bacteria by horizontal gene
transfer. All the isolates were resistant to multiple different
classes of antibiotics, including beta-lactam antibiotics,
fluoroquinolones, and aminoglycosides, but most were still susceptible
to the polymyxin antibiotic colistin.

In early August a chemical compound, GSK-299423, was found to
significantly fight against antibiotic-resistant bacteria by making
such bacteria unable to reproduce, citing a likely treatment to the
NDM-1 strain.[11][12]

Indian response

The Indian health ministry has disputed the conclusion that the gene
originated in India or Pakistan, describing this conclusion as
"unfair" and stating that Indian hospitals are perfectly safe for
treatment.[13] Indian politicians have described linking this new drug
resistance gene to India as “malicious propaganda” and blamed
multinational corporations for what they describe as selective
malignancy.[13][14] A Bharatiya Janata Party politician has instead
argued that the journal article is bogus and represented an attempt to
scare medical tourists away from India.[15] The Indian Ministry of
Health released a statement "strongly refut[ing]" naming the enzyme
"New Delhi".[16]

In contrast, an editorial in the March 2010 issue of the Journal of
Association of Physicians of India blamed the emergence of this gene
on the widespread misuse of antibiotics in the Indian healthcare
system, stating that Indian doctors have "not yet taken the issue of
antibiotic resistance seriously" and noting little control over the
prescription of antibiotics by doctors and even pharmacists.[17] The
Times of India states that there is general agreement among experts
that India needs both an improved policy to control the use of
antibiotics and a central registry of antibiotic-resistant infections.
[18]

The primary author of the 2010 Lancet study, who is based in the
University of Madras, has stated that he does not agree with the part
of the article that advises people to avoid elective surgeries in
India.[18]

References

^ a b Kumarasamy et. al. (2010). "Emergence of a new antibiotic
resistance mechanism in India, Pakistan, and the UK: a molecular,
biological, and epidemiological study". The Lancet Infectious
Diseases. doi:10.1016/S1473-3099(10)70143-2.
^ Jordan, Carol (11 August 2010). "World update: More aid planned for
Pakistan". CNN. http://news.blogs.cnn.com/2010/08/11/world-update-more-aid-planned-for-pakistan/.
Retrieved 13 August 2010.
^ Queenan AM, Bush K (July 2007). "Carbapenemases: the versatile beta-
lactamases". Clin. Microbiol. Rev. 20 (3): 440–58, table of contents.
doi:10.1128/CMR.00001-07. PMID 17630334.
^ Miriagou V, Cornaglia G, Edelstein M, et al. (February 2010).
"Acquired carbapenemases in Gram-negative bacterial pathogens:
detection and surveillance issues". Clin. Microbiol. Infect. 16 (2):
112–22. doi:10.1111/j.1469-0691.2009.03116.x. PMID 20085605.
^ Nordmann P, Cuzon G, Naas T (April 2009). "The real threat of
Klebsiella pneumoniae carbapenemase-producing bacteria". Lancet Infect
Dis 9 (4): 228–36. doi:10.1016/S1473-3099(09)70054-4. PMID 19324295.
^ a b Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, Walsh
TR. (December 2009). "Characterization of a new metallo-beta-lactamase
gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a
unique genetic structure in Klebsiella pneumoniae sequence type 14
from India". Antimicrob Agents Chemother. 53 (12): 5046-54. doi:
10.1128/AAC.00774-09. PMID 19770275. PMC 2786356.
http://aac.asm.org/cgi/content/full/53/12/5046?view=long&pmid=19770275.
^ Muir A, Weinbren MJ (July 2010). "New Delhi metallo-beta-lactamase:
a cautionary tale". J. Hosp. Infect. 75 (3): 239–40. doi:10.1016/
j.jhin.2010.02.005. PMID 20435372.
^ Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-
Lactamase --- United States, 2010
^ McNeil Jr., Donald G. (11 August 2010). "Antibiotic-Resistant
Bacteria Moving From South Asia to U.S.". The New York Times.
http://www.nytimes.com/2010/08/12/world/asia/12bug.html?_r=1&hpw.
Retrieved 13 August 2010.
^ Karthikeyan K, Thirunarayan MA, Krishnan P (July 2010). "Coexistence
of blaOXA-23 with blaNDM-1 and armA in clinical isolates of
Acinetobacter baumannii from India". J Antimicrob Chemother. doi:
10.1093/jac/dkq273. PMID 20650909.
^ Alazraki, Melly (6 August 2010). "GlaxoSmithKline Finds Compound
That Could Help Fight 'Superbugs'". dailyfinance.com.
http://www.dailyfinance.com/story/glaxosmithkline-finds-compound-fight-superbugs/19582888/.
Retrieved 13 August 2010.
^ http://www.indiastudychannel.com/resources/124111-NDM-Origin-Symtoms-Cure-for-NDM.aspx
^ a b Pandey, Geeta (12 August 2010). "India rejects UK scientists'
'superbug' claim". BBC News. http://www.bbc.co.uk/news/world-south-asia-10954890.
Retrieved 13 August 2010.
^ "Linking India to superbug unfair and wrong, says India". Hindustan
Times. 12 August 2010.
http://www.hindustantimes.com/Linking-India-to-superbug-unfair-and-wrong-says-India/Article1-585840.aspx.
Retrieved 13 August 2010.
^ http://expressbuzz.com/nation/superbug-an-mnc-conspiracy-bjp-leader/197607.html
^ Sharma, Sanchita (13 August 2010). "‘Don’t blame superbug on India,
it’s everywhere’". Hindustan Times.
http://www.hindustantimes.com/Don-t-blame-superbug-on-India-it-s-everywhere/Article1-585926.aspx.
Retrieved 13 August 2010.
^ Abdul Ghafur K (March 2010). "An obituary- On the Death of
antibiotics!". Journal of Association of Physicians of India 58.
http://www.japi.org/march_2010/article_01.html.
^ a b Narayan, Pushpa (13 August 2010). "Indian author says superbug
report is fudged". The Times of India.
http://timesofindia.indiatimes.com/city/chennai/Indian-author-says-superbug-report-is-fudged/articleshow/6302479.cms.
Retrieved 13 August 2010.
External links
BBC News Health - Questions&Answers about NDM-1 superbugs
National Resistance Alert 3 addendum in UK (PDF)
[show]v • d • eProkaryotes: Bacteria classification

Domain: Archaea – Bacteria – Eukaryota

G-/
OM Terra-/Glidobacteria Eobacteria (Chloroflexi, Deinococcus-Thermus)
· Cyanobacteria

Gracilicutes Proteobacteria Alpha · Beta · Gamma/Enterobacteriaceae
(Salmonella, Vibrio, Shigella) · Delta · Epsilon (Campylobacter) /
Aquificae (Aquifex)

Planctobacteria Chlamydiae/Verrucomicrobia · Planctomycetes

Sphingobacteria Bacteroidetes/Chlorobi · Fibrobacteres

Other Spirochaetes


Eurybacteria Fusobacteria · Thermotogae

Other/ungrouped Acidobacteria · Chrysiogenetes · Deferribacteres ·
Gemmatimonadetes · Nitrospirae · Synergistetes · Thermodesulfobacteria
· Dictyoglomi


G+/
no OM Actinobacteria Actinobacteridae Actinomycetales Actinomycineae:
Actinomycetaceae (Actinomyces, Mobiluncus)

Corynebacterineae: Mycobacteriaceae · Nocardiaceae ·
Corynebacteriaceae

Frankineae: Frankiaceae

Micrococcineae: Brevibacteriaceae

Bifidobacteriales Bifidobacteriaceae (Bifidobacterium, Falcivibrio,
Gardnerella)


Other subclasses Acidimicrobidae · Coriobacteridae · Rubrobacteridae ·
Sphaerobacteridae


Firmicutes Bacilli Bacillales: Bacillaceae (Bacillus) · Listeriaceae
(Listeria) · Staphylococcaceae (Staphylococcus, Gemella,
Jeotgalicoccus)


Lactobacillales: Enterococcaceae (Enterococcus) · Lactobacillaceae
(Lactobacillus, Pediococcus) · Leuconostocaceae (Leuconostoc) ·
Streptococcaceae (Lactococcus, Streptococcus)

Clostridia Clostridiales (Clostridium, Peptostreptococcus,
Selenomonas) · Halanaerobiales · Thermoanaerobacterales

Tenericutes/
Mollicutes Mycoplasmatales (Mycoplasma, Ureaplasma) ·
Entomoplasmatales (Spiroplasma) · Anaeroplasmatales (Erysipelothrix) ·
Acholeplasmatales (Acholeplasma) · Haloplasmatales (Haloplasma)


note: not all classifications are universally accepted

M: BAC
bact (clas)
gr+f/gr+a(t)/gr-p(c)/gr-o
drug(J1p, w, n, m, vacc)


[show]v • d • eMicrobiology: Bacteria

Pathogenic bacteria Bacterial disease · Coley's Toxins · Exotoxin ·
Lysogenic cycle


Human flora Gut flora · Skin flora · Vaginal flora


Substrate preference Lipophilic · Saccharophilic

Oxygen preference Aerobic (Obligate) · Anaerobic (Facultative,
Obligate) · Microaerophile · Nanaerobe · Aerotolerant

Structures Cell envelope Cell membrane

Cell wall: Peptidoglycan (NAM, NAG, DAP)

Gram-positive bacteria only: Teichoic acid · Lipoteichoic acid ·
Endospore

Gram-negative bacteria only: Bacterial outer membrane (Porin,
Lipopolysaccharide) · Periplasmic space

Mycobacteria only: Arabinogalactan · Mycolic acid

Outside envelope Bacterial capsule · Slime layer · S-layer ·
Glycocalyx
Pilus · Fimbria

Composite Biofilm


Shapes Bacterial cellular morphologies · L-form bacteria · Coccus
(Diplococcus) · Bacillus · Coccobacillus

M: BAC
bact (clas)
gr+f/gr+a(t)/gr-p(c)/gr-o
drug(J1p, w, n, m, vacc)

Retrieved from "http://en.wikipedia.org/wiki/New_Delhi_metallo-beta-
lactamase"

Categories: Bacteriology | Microbiology | Beta-lactam antibiotics | EC
3.5.2

Text is available under the Creative Commons Attribution-ShareAlike

...and I am Sid harth
navanavonmilita
2010-08-13 18:27:20 UTC
Permalink
Post by navanavonmilita
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
E-mail
Share
Print
Comments (2)
Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase
From Wikipedia, the free encyclopedia
ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]
The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.
Function
Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]
cephalosporins
penicillins
carbapenem
The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.
Origin and spread
The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]
In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that it
was susceptible to tigecycline and colistin.
As of June 2010, there were three reported cases of Enterobacteriaceae
isolates bearing this newly described resistance mechanism in the US,
the CDC stated that "All three U.S. isolates were from patients who
received recent medical care in India."[8] However, US experts have
stated that it is unclear if this strain is any more dangerous than
existing antibiotic-resistant bacteria such as methicillin-resistant
Staphylococcus aureus, which are already common in the USA.[9]
In July 2010 a team in New Deli reported a cluster of three cases of
Acinetobacter baumannii bearing NDM-1 that were found in the intensive
care unit of a hospital in Chennai, India in April 2010. As
previously, the bacteria were fully resistant to all the
aminoglycoside β-lactam and quinolone antibiotics, but were
susceptible to tigecycline and colistin. The broad spectrum of
antibiotic resistance was due to the strain bearing several different
resistance genes in addition to NDM-1.[10]
A study by a multi-national team was published in the August 2010
issue of the journal The Lancet Infectious Diseases. This examined the
emergence and spread of bacteria carrying the NDM-1 gene. This
reported on 37 cases in the United Kingdom, 44 isolates with NDM-1 in
Chennai, 26 in Haryana and 73 in various other sites in Pakistan and
India.[1] The authors' analysis of the strains showed that many
carried NDM-1 on plasmids, which will allow the gene to be readily
transferred between different strains of bacteria by horizontal gene
transfer. All the isolates were resistant to multiple different
classes of antibiotics, including beta-lactam antibiotics,
fluoroquinolones, and aminoglycosides, but most were still susceptible
to the polymyxin antibiotic colistin.
In early August a chemical ...
read more »- Hide quoted text -
- Show quoted text -
Drug-resistant 'superbug' found in hospitals in London and Nottingham
By Jenny Hope

Last updated at 11:41 AM on 12th August 2010

Comments (20)

London and Nottingham hospitals placed patients in isolation
Gene makes bacteria resistant to almost all antibiotics
Patients brought enzyme back from India and Pakistan

A hospital in London and another in Nottingham have confirmed they
have treated patients with the new 'superbug', which is resistant to
the most powerful antibiotics.

There are fears that without vigilance the enzyme that allows any
bacteria to become a superbug could become widespread in NHS
hospitals.

It has infected around 50 Britons so far, many of whom returned to the
UK after undergoing surgery in India or Pakistan.
The Health Protection Agency (HPA) yesterday stepped up its warnings
about the new gene called NDM-1, or New Delhi metallo-beta-lactamose
after the place where it was first identified.


Dr David Livermore, director of antibiotic resistance monitoring at
HPA, said resistance to one of the major groups of antibiotics, the
carbapenems, is found throughout India.

'This is important because carbapenems were often the last 'good'
antibiotics active against bacteria that already were more resistant
to more standard drugs.'

The first two patients confirmed to have been infected had traveled
abroad shortly before they were admitted to hospital in the UK.

One patient carrying the tainted bacteria was transferred to a
Nottingham hospital at the end of last year after suffering a trauma
injury in Pakistan.

The UK resident was found to have a colony of the enzyme on their
skin, which means they have been counted as one of the 50 cases.

However, their infection was not as serious as it could have been. In
the worst cases, the enzyme enters the blood stream through an open
wound.

Enlarge

The other patient was treated at St Mark's Hospital in Harrow, London
after being diagnosed with Klebsiella, a bacteria in the gut which
contains the superbug NDM-1.

Staff isolated the patient and a single staff member per shift was
allocated to treating them.

Staff had to wear long sleeve disposable gowns and gloves when in
contact with the patient, enhanced cleaning provisions on the ward,
and restricted visitors to ensure the bug did not spread to other
patients or outside the hospital.

The patient has since been discharged from hospital, and the rooms
used for treatment have been fumigated to ensure no trace of the
superbug remains in the hospital.

More...MICHAEL HANLON: We've only got ourselves to blame for the
indestructible Indian superbug

Meanwhile Dr Tim Boswell, a consultant microbiologist at Nottingham
University Hospitals Trust, said medics were aiming to keep the spread
of the bacteria at bay for as long as possible.

He said: 'It is obviously very rare but it is definitely a cause for
concern that this is a problem for the future.

'We have got methods of surveillance and picking it up early. That
could be a challenge with the high volume of travel in the world.'

The spread of the enzyme that makes any bug 'super'

Rising levels of antibiotic resistance are a threat because there are
few new drugs in the pipeline.

Infection experts are alarmed about the spread of multi-drug
resistance facilitated by the gene NDM-1 that can easily jump from one
strain of bacteria to another.

If it ends up in a bacterium which is already resistant to many other
antibiotics then it could produce infections that are almost
impossible to treat.

NDM-1-producing bacteria are resistant to many existing antibiotics
including carbapenems - a class of drugs often reserved for emergency
use and 'last resort' treatment.

So far two types of bacteria have been host to NDM-1 - the gut bug
E.coli and another that can invade the lungs called Klebsiella
pneumonia.

Both can lead to urinary tract infections and blood poisoning.

E.coli is among a group of 'gram-negative' bugs, and the proportion of
antibiotic-resistant cases of E.coli infection has trebled since the
turn of the century.

There are about 20,000 E.coli bloodstream infections each year in
England, Wales and Northern Ireland, of which more than one in ten is
resistant to antibiotics.

There are just two antibiotics in the pipeline against this group of
infections.
This compares with several new medications for gram-positive
infections like MRSA.

Figures suggest it costs between
£500 million to £1 billion to bring new drugs to market.

GSK, one of a handful of giant pharmaceutial firms actively investing
in antibiotic research, said: 'New antibiotics that work in different
ways to existing medicines are desperately needed to tackle the rising
incidence of antibiotics resistance.'

Dr Livermore warned: 'Few antibiotics remain active against these
bacteria.

'Their spread underscore the need for good infection control in
hospitals both in the UK and overseas, and the need for new antibiotic
development.'
The HPA flagged up enzyme problem last year but renewed its warnings
after a study in journal The Lancet Infectious Diseases tracked the
emergence of the 'superbug' gene in different countries.

The researchers found NDM-1 is becoming more common in Bangladesh,
India and Pakistan and is starting to be imported back to Britain in
patients returning from these countries.

Several of the British NDM-1 positive patients had recently travelled
to the Indian subcontinent for hospital treatment including cosmetic
surgery.

Timothy Walsh, professor of medical microbiology and antimicrobial
resistance at Cardiff University, who led the study, said it was a
'real concern'.

'Because of medical tourism and international travel in general,
resistance to these types of bacteria has the potential to tavel
around the world very, very quickly.'

He said there are few drugs in development that can potentially combat
the threat.

The resistant gene has also been detected in Australia, Canada, the
US, the Netherlands and Sweden.

The NDM-1 gene alters bacteria, making them resistant to nearly all
known antibiotics.

It has been largely found in E. coli bacteria, the most common cause
of urinary tract infections, and on DNA structures that can be easily
copied and passed onto other types of bacteria.

The researchers said the superbug gene appeared to be already
circulating widely in India, where the health system is much less
likely to identify its presence or have adequate antibiotics to treat
patients.

Christopher Thomas, professor of molecular genetics at the University
of Birmingham who was not linked to the study, said 'We are
potentially at the beginning of another wave of antibiotic resistance,
though we still have the power to stop it.'
Prof Thomas said better surveillance and infection control procedures
might halt the gene's spread.
Although patients in British hospitals are unlikely to encounter the
superbug gene, they should remain vigilant about standard hygiene
measures like properly washing their hands, he added.

'The spread of these multi-resistant bacteria merits very close
monitoring' wrote Johann Pitout of the division of microbiology at the
University of Calgary, Canada, in an accompanying Lancet commentary.

He called for international surveillance of the bacteria, particularly
in countries that actively promote medical tourism.
'The consequences will be serious if family doctors have to treat
infections caused by these multi-resistant bacteria on a daily basis'
he added.

The Department of Health spokesman said 'We are working with the
Health Protection Agency. The HPA alerted the NHS in January and July
lst year to be vigilant about these bacteria and take appropriate
action where necessary.
'Hospitals need to ensure they continue to provide good infection
control to prevent any spread, consider whether patients have recently
been treated abroad and send samples to the HPA for testing.'


Comments (20)

Here's what readers have had to say so far. Why not add your thoughts
below, or debate this issue live on our message boards.

The comments below have not been moderated.


There has being a problem with antibiotics and their over use in the
UK for years there are safer alternatives,check on line,do your own
research.
- kathryn, aberystwyth, 13/8/2010 11:56
Rating 1

Is writing in capitals recommended in the guide to being a conspiracy
theorist?
- P, Southampton, 13/8/2010 10:52
Rating 4

Important thing is these superbugs are killing Indians for a long time
now. The deaths are just passed over as "septicemia deaths". But no
disinfection protocols are followed and no records are maintained. On
an average 10-15 Indians die because of this bacteria. Only the
reports are suppressed. Typical symptoms are

1. High fever about 104F, little remission on drug administration for
1-2 hour.
2. Difficulty in breathing, but the oxygen saturation level remains
steady. Ventillator required after 48hours.
3. No response to any antibiotic. Death results sooner if you are
suffering from other diseases.
4. Death & Multiple organ failure.

If anyone/media wants to verify this, just go to any reputed hospital
in India, ask them for RECORD and PROTOCOL in the event of "Septicemia
Deaths". They wont have any.
- san, Delhi, India, 12/8/2010 19:42

Rating 7

Typical. Vanity puts the rest of us at risk by the usual Sun reading
public who follow the 'Celeb' culture because they have no
intelligence. Fancy going to a third world country and have an
operation on the cheap? Morons.
- Playboy, bucks, 12/8/2010 17:50

Rating 9

To Thunder on the Right and ilk: Then you must consider the American
health care system a failure, as well, since so many Americans travel
outside the U.S. for treatments like this. Put your socialized public
education to use by reading the article again, but this time pay
attention to what kinds of procedures people are going for--Elective
cosmetic procedures and gray-market transplants.
- Rob, Lawrence, KS, 12/8/2010 16:14

Rating 7

To Thunder on the Right: Then you've got to consider the U.S. medical
system broken, as well, since so many Americans travel outside the
country for the same kinds of treatments. Read the article again and
pay attention to just what kinds of surgeries we're talking about.
Many of them are elective cosmetic procedures or black-market
transplants.
- Rob, Lawrence, KS, 12/8/2010 16:07
Rating 1

Read more:

http://www.dailymail.co.uk/health/article-1302432/Drug-resistant-NDM-1-superbug-London-Nottingham-hospitals.html?ITO=1490#ixzz0wW1lpqtw
navanavonmilita
2010-08-13 18:29:34 UTC
Permalink
Post by navanavonmilita
Post by navanavonmilita
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
E-mail
Share
Print
Comments (2)
Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase
From Wikipedia, the free encyclopedia
ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]
The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.
Function
Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]
cephalosporins
penicillins
carbapenem
The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.
Origin and spread
The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]
In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that it
was susceptible to tigecycline and colistin.
As of June 2010, there were three reported cases of Enterobacteriaceae
isolates bearing this newly described resistance mechanism in the US,
the CDC stated that "All three U.S. isolates were from patients who
received recent medical care in India."[8] However, US experts have
stated that it is unclear if this strain is any more dangerous than
existing antibiotic-resistant bacteria such as methicillin-resistant
Staphylococcus aureus, which are already common in the USA.[9]
In July 2010 a team in New Deli reported a cluster of three cases of
Acinetobacter baumannii bearing NDM-1 that were found in the intensive
care unit of a hospital in Chennai, India in April 2010. As
previously, the bacteria were fully resistant to all the
aminoglycoside β-lactam and quinolone antibiotics, but were
susceptible to tigecycline and colistin. The broad spectrum of
antibiotic resistance was due to the strain bearing several different
resistance genes in addition to NDM-1.[10]
A study by a multi-national team was published in the August 2010
issue of the journal The Lancet Infectious Diseases. This examined the
emergence and spread of bacteria carrying the NDM-1 gene. This
reported on 37 cases in the United Kingdom, 44 isolates with NDM-1 in
Chennai, 26 in Haryana and 73 in various other sites in Pakistan and
India.[1] The authors' analysis of
...
read more »- Hide quoted text -
- Show quoted text -
BOOSTER SHOTS: Oddities, musings and news from the health word

Fears of a new superbug from Asia may be overblown, experts say

August 13, 2010|10:22 a.m.

la-heb-superbug-20100813

British researchers said Tuesday that a new bacterium resistant to
most antibiotics is becoming more common in India and Pakistan and
that it has been identified in 37 people in the U.K., primarily among
people who have traveled to that region to receive cheaper medical
care. U.S. authorities say that three cases of the infection have also
been detected in this country. The outbreak is concerning, the
researchers reported online in the journal Lancet Infectious Diseases,
because the bug is resistant to a family of newer antibiotics called
carbapenams, which are generally reserved for treating bacteria
resistant to most other antibiotics.

However, experts said there is no evidence that the new resistant
organisms, powered by a mutant gene called NDM-1 that confers
resistance, is any more dangerous that the methicillin-resistant
Staphylococcus aureus (MRSA) that has become widespread in the United
States or any of a number of other carbapenam-resistant organisms that
have been observed previously. The new organism is simply "one of a
number of very serious bugs we're tracking," Dr. Alexander J. Kallen
of the Centers for Disease Control and Prevention told the New York
Times. He said the CDC has observed no more new cases in this country
since its initial warning in June.

Experts also said that there are at least two older antibiotics that
can attack carbapenam-resistant organisms: colistin, which may have
some side effects, and Tygacil, manufactured by Pfizer. Pharmaceutical
companies are also developing a number of other new antibiotics, a
market that is currently viewed as potentially lucrative.

In the Lancet study, researchers headed by Dr. Timothy Welsh from
Cardiff University collected specimens from hospitals and community
medical centers in Bangladesh, India and Pakistan. The team found the
mutant gene in 36 samples of Escherichia coli, one of the most common
causes of urinary infections, and in 111 samples of Klebsiella
pneumoniae, which causes lung infections. The mutant strains were
resistant to all antibotics except Tygacil and colistin, and some
samples were resistant to those as well. The team said nothing about
the fate of the infected patients.

India and Pakistan have developed some excellent hospitals and
surgeons that provide medical care and surgical procedures, especially
elective procedures, more cheaply than they are available in the West.
But the overuse of antibiotics among the larger population leads to
the development of resistance, and those organisms can make their way
into even the best hospitals.

For the moment, most people agree, the new organisms are not an
immediate threat in the West. But authorities caution that anyone who
becomes ill after visiting Asia for medical procedures should be
carefully screened for the new organisms.

Thomas H. Maugh II / Los Angeles Times

Copyright © 2010, Los Angeles Times

...and I am Sid Harth
navanavonmilita
2010-08-13 18:31:35 UTC
Permalink
Post by navanavonmilita
Post by navanavonmilita
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
E-mail
Share
Print
Comments (2)
Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase
From Wikipedia, the free encyclopedia
ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]
The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.
Function
Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]
cephalosporins
penicillins
carbapenem
The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.
Origin and spread
The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]
In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that it
was susceptible to tigecycline and colistin.
As of June 2010, there were three reported cases of Enterobacteriaceae
isolates bearing this newly described resistance mechanism in the US,
the CDC stated that "All three U.S. isolates were from patients who
received recent medical care in India."[8] However, US experts have
stated that it is unclear if this strain is any more dangerous than
existing antibiotic-resistant bacteria such as methicillin-resistant
Staphylococcus aureus, which are already common in the USA.[9]
In July 2010 a team in New Deli reported a cluster of three cases of
Acinetobacter baumannii bearing NDM-1 that were found in the intensive
care unit of a hospital in Chennai, India in April 2010. As
previously, the bacteria were fully resistant to all the
aminoglycoside β-lactam and quinolone antibiotics, but were
susceptible to tigecycline and colistin. The broad spectrum of
antibiotic resistance was due to the strain bearing several different
resistance genes in addition to NDM-1.[10]
...
read more »- Hide quoted text -
- Show quoted text -
Superbug may originate from India - study
13/08/2010 12:45:00 admin
Font size:

Superbug found in the United Kingdom may come from India through some
patients who sought to receive some cosmetic or plastic surgery in the
Asian country, British scientists suggest in a study published in the
journal The Lancet.


The superbug with an enzyme known as NDM-1 short for New Delhi metallo-
beta-lactamase, which confers drug resistance to all antibiotics
including the most recently developed antiobitic named Carbapenem, is
more dangerous than MRSA -Methicillin-resistant Staphylococcus aureus,
which is resistant to some antibiotics.


The researchers said UK patients infected with the superbug with the
NDM-1 gene got the pathogen from India.


Indian lawmakers reportedly complained that the infection of this
superbug can occur anywhere in the world saying that it is a
conspiracy that UK scientists' suggest that the superbug originates in
India. They pointed out the UK study was sponsored by drug companies
and there was conflict of interest.


They said this allegation created a unfair scare that could
potentially damage the country's medical tourism business. India is
one of most popular destination for medical tourism. Many people go
to the country to receive plastic surgery.


In addition to India, Pakistan, and the UK, United States has also
reported cases of NDM-1 in some states.


Last year, the Centers for Disease control and Prevention issued a
guidance for control of infections with carbapenem-resistant or
carbapenemase-producing Enterobacteriaceae in the March 20, 2009 issue
of Morbidity and Mortality Weekly Report (MMWR).


In the report, editors say that the gene which is responsible for a
carbapenemase enzyme, that is, beta-lactamase, but unidentified at the
time, is a mobile gene or transposon, which can jump from one
microorganism to another, increasing the risk of dissemination.


The enzyme has been found in 24 states ever since first described in
North Carolina in 1999. It is now recovered routinely in some
hospitals in the New York and New Jersey, the CDC says in its MMMR
report. The gene was found in 8 percent of all Klebsiella pneumoniae
isolates.


In 2008, one outbreak resulting in 39 cases of carbapenem-resistant
Klebsiella pneumoniae occurred in a hospital in Puerto Rico.


Carbapenems including imipenem and meropenem, are the most potent β-
lactam antibiotics indicated to fight drug resistant gram-negative
bacteria. There are fewer antibiotics for treating gram-negative
bacteria compared to drugs for treating gram-positive bacteria like
MRSA, according to New York Times.


Carbapenem-resistant Klebsiella pneumoniae is more commonly seen than
carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in
the United States, according to the CDC report.


The CDC recommends that all acute facilities should implement contact
precautions for patients colonized or infected with Carbapenem-
resistant Klebsiella pneumoniae or carbapenemase-producing
Enterobacteriaceae. But no recommendation is made as to when to
discontinue contact precautions.


On June 25, 2010, the CDC reported in a June 25 MMWR that three
Enterobacteriaceae isolates carrying a newly described resistance
mechanism, the New Delhi metallo-beta-lactamase (NDM-1), were
identified from three U.S. states at the CDC antimicrobial
susceptibility laboratory.


These isolates including an Escherichia coli, Klebsiella pneumoniae,
and Enterobacter cloacae carried blaNDM-1, which confers drug or
antibiotic resistance.


The CDC cited one early report as saying the superbug
Enterobacteriaceae containing NDM-1 found in UK patients was
associated with medical care from India and Pakistan. And the three
U.S. isolates came from patients who actually received medical care in
India.


This report says that once a superbug is identified, the isolate
should be sent to the CDC within 6 months for further characterization
and infection control interventions should be implemented to prevent
transmission of the pathogen.


By Jimmy DownsAdd to: del.icio.us | Digg
Comments (10 posted):
BobbyMcBobberton on 13/08/2010 15:01:10

Oh NO!!! NOT IMIPENEM AND MEROPENEM!!! Those are the two worst penems
there are! And we all know that ?-lactam antibiotics are frammed up
the rammastam when it comes to gram-negative bacteria.

I used to farm Carbapenem-resistant Klebsiella pneumoniae back before
the 3rd reconcilliation of the pataris alkabeedis supplication in '77.
This is OBVIOUSLY more commonly seen than carbapenem-resistant or
carbapenemase-producing Enterobacteriaceae. DUH! You didn't need the
CDC to tell us THAT!!!

For real. Who the hell was this article written for? And do you think
anyone might be interested to know WHAT THE FRECK THE BUG *DOES*!??
Bleeding out the orifaces? Whooping cough!?

Holy god, you suck as a writer. Somebody fire this guy. What a waste
of internet.

0 g on 13/08/2010 15:18:07

I have to agree. After reading this, I don't know if I should be
scared or what it will do.

Perhaps it just eats the botox from the plastic surgery?

0 Ken Hovanes on 13/08/2010 15:29:24

There is a enzyme called NDM-1 which is easily transferred between
bacteria (infections). The single most dangerous trait of this enzyme
is that it dramatically increases antibiotic resistance in bacteria
which have adopted the gene.

So... it means... it's not a SPECIFIC infection they are concerned
about, it's related to ALL infections. An infection, like say, TB...
if it were to acquire the resistance characteristics from the NDM-1
enzyme, that would be very bad, as it would be resistant to virtually
every antibiotic currently available.

0 Terrence Hohnhorst on 13/08/2010 15:35:10

If they can wait six months to send in for
further tests how bad can this be. From a
lay person scientist / non medical.

0 NM on 13/08/2010 15:40:30

This is very important because if it does spread amongst bacterial
organisms, it basically makes all of our scientific achievements
completely worthless in terms of being able to fight infection.

Imipenem/Cilastin and Merrem are both very expensive drugs which were
produced to help solve the relative shortage of gram-negative-
effective bacteriostatics/anti-bacterials.

Anyone who scoffs at this news is ignorant, and I highly encourage you
to learn more. This is very bad news. Very bad.

0 Ed Hoarse on 13/08/2010 16:16:40

Guess we will just have to go back to sulfur drugs, honey, nano
silver, leeches and chicken soup.

0 George Meredith MD on 13/08/2010 16:55:31

The CDC rarely points out that MSRA and, now, NDM-1, infections almost
always are related to some (foreign body) implant. Silastic being one
of the worst!

Basic surgical principals. Irrigate wound at end of operation with
strong penicillin solution. If infection occurs, usually on the third
postoperative day, then, open wound widely. Change plain one inch
Nuguaze Packing daily Don't rely on some super antibiotic. Get back to
basics!

Search: George Meredith MD Comments for more information.

High dose IV Aqueus Penicillin was the drug of choice before the FDA
removed it from the marketplace.

Those phony little C&S discs, Dr Fauuci, give completely different
sensitivity results when the conentration of penicillin is increased
ten fold, stupid!

"The best government is the least government."

George Meredith MD
Virginia Beach

0 Philip V. on 13/08/2010 17:08:41

Great letter, Bobbie. I remember the 3rd Reconcilliation back in '77.
It was a nightmare.

0 Andrew on 13/08/2010 17:21:18

Thank you Dr. for adding the information about this usually being
related to some type of foreign body implant. Any informaion helps. I
also agree with teh previous commnets; this article really needs to be
written for teh masses, in simple terms so the majority can
understand. This is a very important subject and people need to
understand the implications.

0 Charlie on 13/08/2010 18:01:59

I think perhaps some scientist are jumping the gun to early. It is
important and many diseases to exist or originate in other countries,
however perhaps they should show the actual statistics (numbers) of
how many versus, how many have not contacted the disease, versus how
many total surgical procedures have been done.

Charlie

...and I am Sid Harth
navanavonmilita
2010-08-13 18:32:59 UTC
Permalink
Post by navanavonmilita
Post by navanavonmilita
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
E-mail
Share
Print
Comments (2)
Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase
From Wikipedia, the free encyclopedia
ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]
The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.
Function
Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]
cephalosporins
penicillins
carbapenem
The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.
Origin and spread
The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]
In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that it
was susceptible to tigecycline and colistin.
As of June 2010, there were three reported cases of Enterobacteriaceae
isolates bearing this newly described resistance mechanism in the US,
the CDC stated that "All three U.S. isolates were from patients who
received recent medical care in India."[8] However, US experts have
stated that it is unclear if this strain is any more dangerous than
existing antibiotic-resistant bacteria such as methicillin-resistant
Staphylococcus aureus, which are already common in the USA.[9]
In July 2010 a team in New Deli reported a cluster of three cases of
Acinetobacter baumannii bearing NDM-1 that were found in the intensive
...
read more »- Hide quoted text -
- Show quoted text -
Wales News ‘Superbug’ could trigger death rates last seen before
antibiotics were in use
Aug 13 2010 by Clare Hutchinson, Western Mail
THE expert who discovered a new superbug resistant to even the most
powerful antibiotics has warned that a “worst-case scenario” could see
death rates at levels last seen in the 1920s.

The world’s population has exploded from 2bn people 80 years ago to
more than six billion today since Alexander Fleming’s discovery of
penicillin in 1928 and the subsequent mass-production of the drug in
the late 1940s.

Professor Timothy Walsh of Cardiff University said the NDM-1 gene
could see mortality rates return to where they were before the
discovery of penicillin.

Prof Walsh co-authored a paper published in The Lancet that revealed
37 people in the UK had been infected with the NDM-1 gene (New Delhi
metallo-ß-lactamase 1) that is resistant to most antibiotics.

He said the discovery could herald an era in which antibiotics become
redundant.

He said: “We have a definite window of about 10 years in which we
would need to design new and novel ways to tackle these resistant
forms of bacteria but even if somebody from somewhere designs this new
thing, that no one has discovered before, it would still take 10 years
to develop.

“The problem we have got is that bacteria can multiply every 20 to 30
minutes and when that happens they can re-arrange their DNA very
rapidly – far faster than we ever could hope to develop new classes of
antibiotics.

“Unfortunately, because they are able to do this and transfer their
DNA from one to the other we are always going to be behind.

“That is what has happened with NDM-1 somewhere, possibly in India. In
this case it will have spread like wildfire through the Indian
community, but if you went back three or four years ago you probably
wouldn’t find it – that is how quickly it has developed.”

He added: “We have 37 to 50 cases here and that is a far cry from the
thousands and thousands of MRSA cases that are reported in the UK
every year, but the problem with this is that we have five or six
antibiotics which you can use for MRSA but just two for NDM-1.

“The risk is that it won’t take long for the bacteria to build up a
resistance to both of these.

“Ultimately with serious infections you can expect a higher level of
mortality because we will have nothing with which to fight off the
infection.”

Prof Walsh also warned that thousands of people in Wales could be
carrying antibiotic-resistant bacteria without even knowing.

He said anyone who had travelled to India, Bangladesh or Pakistan
could be at risk.

“There is certainly an element of what we are seeing being the tip of
the iceberg,” he said.

“We have about 100 trillion bacteria living in our bodies and if one
with this resistant gene gets in it has the potential to transfer that
resistance over to other bacteria in the gut.

“Because it is part of the normal flora of your body, there is an
element of silence about it – it doesn’t glow in the dark.”

In his report, Professor Walsh and his colleagues said patients who
went to India and Pakistan for treatments such as cosmetic surgery had
come back with bacteria that make the NDM-1 enzyme.

Yesterday India rejected the claim, with officials describing it as
“malicious propaganda”.

Professor Walsh said there did appear to be a link to India, but
insisted visitors to the country would be safe if they took simple
precautions.

He said: “I’ve been to India recently so there is an outside chance
that I could be carrying it.

“What we are not saying is ‘don’t go to India’. People shouldn’t be
scared about travelling there, just drink bottled water and be careful
of what you eat.

“What we are saying is that people who opt for surgery in India need
to think very hard before they do so.”

The paper, published in The Lancet Infectious Diseases by Professor
Walsh and his colleagues, said the emergence of the new strain of
superbug had worried them because of its ability to spread across
continents and its resistance to both “work-horse” and specialist
antibiotics.

Scientists believe that the overuse of antibiotics has contributed to
bacteria developing this resistance.

While at present all antibiotics require a prescription in the UK,
they are available over the counter in other countries.

Ministers in the UK are now considering banning future
reclassifications of antibac-terial drugs to prevent them ever being
sold over the counter.

But Professor Walsh called the move “shutting the stable door after
the horse has bolted” and said a worldwide effort was needed to bring
infection under control and curb the use of antibiotics.

“A move like that would have some effect but you could argue that it
is shutting the stable door after the horse has bolted.

“In the UK we have a very good hospital infection control policy but
unfortunately other countries have less stringent policies and lighter
controls on antibacterial usage.

“It is a bit like global warming – it’s a global phenomenon and you
can just look at the UK but quite frankly that’s not particularly
helpful.”

Last night a spokesman for the Assembly Government said: “Antibiotics
are important medicines used to treat infections caused by bacteria
and the use of antibiotics has saved countless lives since they were
developed.

“However, taking antibiotics when they are not needed or not taking
them correctly will lead to more bacteria becoming resistant to them.

“We therefore need to reduce our reliance on the prescription of
antibiotics for common ailments that could be managed in other ways.”

...and I am Sid Harth
navanavonmilita
2010-08-13 18:36:24 UTC
Permalink
Post by navanavonmilita
Post by navanavonmilita
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
E-mail
Share
Print
Comments (2)
Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase
From Wikipedia, the free encyclopedia
ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]
The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.
Function
Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]
cephalosporins
penicillins
carbapenem
The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.
Origin and spread
The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]
In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that it
was susceptible to tigecycline and colistin.
As of June 2010, there were three reported cases of Enterobacteriaceae
isolates bearing this newly described resistance mechanism in the US,
the CDC stated that "All three U.S. isolates were from patients who
received recent medical care in India."[8] However, US experts have
...
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Fighting superbugs
Published: August 11 2010 22:21 | Last updated: August 11 2010 22:21

Reports of the emergence of new bacteria in the Indian sub-continent
that are resistant to almost all antibiotics, and their increasing
spread around the world, are sobering reminders of the need to take
infection more seriously.

It is only six decades since penicillin heralded a revolution in
medical treatment, which has since been taken too much for granted.
Only two new classes of antibiotics have been introduced in the past
40 years, while resistance is levying an increasing burden on patients
and healthcare systems.

EDITOR’S CHOICE

Lex: Charles River / Wuxi - Jul-30Lex: Roche v the FDA -
Jul-21Brussels watchdog accuses Servier - Jul-27Watchdog given rebuke
on drugs pacts probe - Jul-19FDA calls for change on GSK’s Avandia -
Jul-14John Gapper: Politicians should not prescribe pills - Jul-14The
rise in global travel and cross-border “medical tourism” redouble the
need for a more aggressive and co-ordinated international response,
since bacteria respect no borders.

A first lesson is the need for more responsible use of the limited
range of antibiotics currently in use, to limit the spread of
resistance that will render them useless. That means more restricted
prescribing by doctors; more scrupulous efforts by patients to take
the full course of treatments they are given; and less indiscriminate
veterinary use of antibiotics to promote animals’ growth.

A second imperative is more scrupulous approaches to hygiene,
especially in hospitals where many such infections are transmitted,
often brought in by patients themselves. That requires more systematic
screening and isolation of those judged at-risk, improved cleaning and
more frequent changes of catheters.

There must also be more careful and transparent monitoring of
infections, and rewards for managers who succeed in reducing the
impact. Many countries with lower reported rates of hospital-acquired
infections are simply not doing enough to even measure the true extent
of the problem.

But the laws of nature mean that bacterial resistance will inevitably
occur, while the constraints of commerce and science have left a large
hole in the pipeline of new products that are required. Research on
innovative antibiotics is difficult, and the incentives are modest
compared with many other categories of pharmaceuticals.

The European Union and the US have launched joint initiatives in
recent months to recognise the need for innovative approaches, such as
public-private partnerships, easier regulatory approval, and funding
and pricing benefits. Detailed recommendations are due by the end of
next year.

This week’s Indian-derived superbugs should serve as a reminder to
policymakers that they must meet their schedules.

Copyright The Financial Times Limited 2010.


Indiancat | August 13 11:30am

the old english trick. when you can't beat them, create confusion. the
same is happening in this case. for long english do not know how to
counter the growing influence of the Indian medicos strengths and
indian hospitals which are now world class and in some cases even
better than what you get around. this is good way of confusing already
traumatized population for safety, of the prospective health treatment
seekers in India. this be known that their own issues are going to
defeat any such misinformation tricks. GoI/hospitals in India should
thoroughly probe this and file a huge suit against these people and
win this.

alby1800 | August 13 11:28am |

Just another British media propoganda as mentioned in Indian media.

ricemary | August 12 11:38am |

In hospitals today patients move beds several times per hospital
visit. They are admitted to A&E and are no longer allowed to wait
there for hours until a bed is available on the most suitable ward.
Instead they are moved within the "4 hour wait" to some kind of
holding ward near the A&E department, then usually moved on to a
medical assessment unit for a further 24 hours and then onwards
towards the ward of the correct destination. Then of course are the
visits to the X ray department, maybe the operating theatre or the
intensive care unit. Cutting down the number of bed moves is likely to
radically reduce the spread of resistent infections.

Sunil | August 12 9:52am |

"The researchers found a gene that enables the bacteria to resist
treatment with a class of antibiotics called carbapenems in 1.9
percent of samples from patients in the Indian states of Tamil Nadu
and Haryana (two out of over two dozen states in India) - Lancet"

If this is a genuine concern, I think the world needs to take it
seriously and patients from 'developed western countries" should be
educated about 'dangers' of getting treated in India.

But, if it is just another 'protectionist' measure through slow and
steady negative media campaign, which we've all too familiar since Mr
Obama and Mr. Cameron took the office, it is just shame on the so
called 'free capitalism preaching developed first world nations'. No
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...and I am Sid Harth
navanavonmilita
2010-08-13 18:41:51 UTC
Permalink
Post by navanavonmilita
Post by navanavonmilita
Post by navanavonmilita
India is SHIT-Scared About New Delhi Metallo-1: Sid Harth
Fear And Loathing In India Over 'Superbug' Study
Categories: Health, Foreign News
12:22 pm
August 13, 2010
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Recommend (3)
by Scott Neuman
Indian officials are trotting out conspiracy theories to explain away
a report in the respected British medical journal, The Lancet, that a
drug-resistant "superbug" (an enzyme that infects bacteria, actually)
had been picked up by medical tourists to the South Asian country.
The enzyme has been, at least from the Indian perspective, unhelpfully
named after the country's capital: it's called New Delhi-Metallo-1, or
NDM-1.
Indian Health Minister Ghulam Nabi Azad has asked publicly whether
'ulterior motives' were at work with the Lancet paper, noting that
foreign pharmaceutical companies that produce antibiotics had provided
some of the funding.
It (superbug) is universal and is found in the intestine of humans and
animals. It is wrong to say that it is found only in India and
Pakistan. They say it was found in patients who visit India and
Pakistan. The study nowhere mentions if the bacteria were found even
before those persons visited India.
A prominent member of the main opposition Hindu-nationalist party, the
BJP, echoed the implication that foreign pharmaceutical companies
might be pulling the strings and expressed concern that it could hurt
India's burgeoning medical tourism industry. The Hindustan Times
It may be a sinister design of multinational companies around the
world," he said, adding that with globalisation, it was not just
populations that were migrating, but also virus [sic] and bacteria.
A bit more perspective in The Times of India story had the CEO of
India's chain of Apollo Hospitals calling for "an approach that is
more corrective than alarmist."
India, like Thailand, has become a medical tourism mecca, as
foreigners flock there to get cheaper - and frequently better -
medical care than in their home countries.
Comments
I second what (Aboo) said, a school dropout can become a doctor while
hospitals like Apollo is not employing them, they are called RMP(rural
medical practitioners) my problem with these people is they prescribe
all the antibiotics possible in Pharmacopoeia even for simple viral
infection they prescribe ceftrioxone, azithromycin etc wile it works
for the patient who would then take it for two or three days this what
makes a superbug resistant to all known antibiotics.
when I did my MBBS(MD) in nepal there was a epidemic of Typhiod fever,
6 nurses dies within few days, our microbiology lab showed that the
bug is resistent to all the antibiotics then we have to device a
dosage higer than normal at the same time maintain it below toxic
levels hen after few doctors themselves becoming sick we could control
the infection.
Instead of blaming lancet Gov of India should take stringent measures
to curb this practice of dispensing medicine by non-medicos.
this genarates what is called superbug
Friday, August 13, 2010 1:47:53 PM
Recommend (0)
Report abuse
Having grown up in that part of the world I am inclined to believe
that the report in the Lancet is correct.
In India and Pakistan dispensing of medicine is totally unregulated
and uncontrolled. As a matter of fact NOTHING is regulated or
controlled. Corruption is so rampant that if you have the money you
can get anything, or get anything done.
Accordingly, pharmacies, or 'medical stores' as they are known there,
are everywhere. You need no licence to open one and once you open one
you'll be known as a 'doctor' after a few months. Even if you haven't
seen the inside of an elementary school. Then you can dispense
whatever you want to the illiterates and ignorants and even the
educated, who come to you. For just the price of cheap, and often
fake, medicine they need no prescription.
This free-for-all medical practice over decades has resulted in
absolute gross misuse of antibiotics. And resistance to antibiotics
has been a known phenomenon, and talked about in real medical circles,
for decades. Now it is just that these countries have begun exporting
their ignorance and arrogance-created problem to the rest of the
world..
Friday, August 13, 2010 1:14:56 PM
Recommend (1)
Report abuse
...and I am Sid Harth
New Delhi metallo-beta-lactamase
From Wikipedia, the free encyclopedia
ND Metallo-beta-lactamase (NDM-1)[1] is a gene that makes bacteria
resistant to antibiotics of the carbapenem family. The gene is one
member of a large gene family that encode beta-lactamase enzymes
called a carbapenemase. The NDM-1 enzyme inactivates a broad range of
beta-lactam antibiotics. Bacteria that carry such genes are often
referred to in the news media as "superbugs."[2]
The NDM-1 gene was first identified in a patient who was hospitalised
in New Deli and the gene has since been detected in bacteria in India,
Pakistan, the United Kingdom and the United States. The most common
organisms carrying this gene are the gram-negative bacteria E.coli and
Klebsiella pneumoniae, but the gene can be transmitted from one strain
of bacteria to another through horizontal gene transfer. This is in
contrast to the more familiar antibiotic resistant bacteria such as
Methicillin-resistant Staphylococcus aureus, which are gram-positive.
Function
Carbapenems are a class of beta-lactam antibiotics were, until
recently, capable of killing most bacteria by inhibiting the synthesis
of one of their cell wall layers. The carbapenems were developed to be
less sensitive to inactivation by the beta-lactamse enzymes that had
evolved in bacteria resistant to antibiotics such as penicillin. The
NDM-1 gene produces a carbapenemase beta-lactamase, which is an enzyme
that hydrolyzes and inactivates these carbapenem antibiotics.
Carbapenemases are particularly dangerous resistance mechanisms, since
they can inactivate a wide range of different antibiotics.[3] The
NDM-1 enzyme is a class B metallo-beta-lactamase, while other types of
carbapenemase are class A or class D beta-lactamases.[4] The class A
Klebsiella pneumoniae carbapenemase is the most common type of this
enzyme and was first detected in North Carolina, USA, in 1996 and has
since spread worldwide.[5]
cephalosporins
penicillins
carbapenem
The resistance conferred by this gene therefore aids the expansion of
bacteria that carry it throughout a human host, since they will face
less opposition/competition from populations of antibiotic-sensitive
bacteria, which will be diminished by the original antibacterial
treatment.
Origin and spread
The resistance gene has been found in Pakistan, India and most other
Asian countries and has been brought to Europe by people undergoing
hospitalization in those countries. The gene was named after New
Delhi, the capital city of India, as it was first described by Yong et
al. in December 2009 in a Swedish national who fell ill with an
antibiotic-resistant bacterial infection that he acquired in India.[6]
The infection was unsuccessfully treated in a New Delhi hospital and
after the patient's repatriation to Sweden, a carbapenem-resistant
Klebsiella pneumoniae strain bearing the novel gene was identified.
The authors concluded that the new resistance mechanism "clearly arose
in India, but there are few data arising from India to suggest how
widespread it is."[6]
In May 2010 a case of infection with E. coli bearing NDM-1 was
reported in Coventry in the United Kingdom.[7] The patient was a man
of Indian origin who had visited India 18 months previously, where he
had undergone dialysis. In initial assays the bacteria was fully
resistant to all antibiotics tested, while later tests found that
...
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Indian doctors warned of superbug before Lancet study
AFP August 13, 2010 9:01 AM


An electron microscope is seen in a laboratory. Indian doctors
warned earlier this year about the threat from a new multi-drug
resistant 'superbug' -- months before a British study that New Delhi
has condemned for scaremongering.Photograph by: Eric Piermont, AFP/
Getty ImagesMUMBAI — Indian doctors warned earlier this year about the
threat from a new multi-drug resistant "superbug" -- months before a
British study that New Delhi has condemned for scaremongering.

A team of researchers from a leading private hospital in Mumbai came
to similar conclusions as the British study, which warned that
foreigners coming to India for cut-price treatment could pick up NDM-1
and spread it worldwide.

India's health ministry angrily dismissed the claim in the medical
journal The Lancet as exaggerated and unfair, while some politicians
saw it as a conspiracy designed to scupper the country's booming
health tourism industry.

But Indian researchers themselves had said in March that they found 22
incidences of "New Delhi metallo-lactamase-1" producing bacteria in 24
infection cases between August and November last year.

"This high number in a relatively short span is a worrisome trend,"
the team from the Hinduja hospital said in the Journal of the
Association of Physicians of India.

Equally worrying is the fact that NDM-1-carrying bacteria are
resistant even to carbapenems, a group of antibiotics often reserved
as a last resort for emergency treatment for multi-drug resistant
bugs.

"The growing incidence and also the diversity of carbapenemase-
producing strains is therefore of major concern," the researchers
added, warning that the superbug "has the potential for further
dissemination in the community".

The Indian team said they did not know the exact prevalence of NDM-1
but added that its spread "may endanger patients undergoing major
treatment at centres in India and this may have adverse implications
for medical tourism".

An Australian infectious diseases specialist on Friday said three
people who had travelled to India for treatment had contracted the
infection and the cases could be just the "tip of the iceberg", amid
concern about its global spread.

Dr K. Abdul Gharfur, a consultant on infectious diseases in the
southern city of Chennai, has said that the Indian medical authorities
are in denial about the extent of multi-drug resistant infections.

He told AFP on Friday that no country was immune to the problem but it
was likely to be more acute in places like India because of a lack of
effective controls on the prescription of antibiotics.


"This bacteria, NDM-1, is increasing. It's true it's spreading in
India. I'm sure it exists in almost every major hospital in India. But
we have limited data," he said.


Few hospitals, including in the private sector, have specialist
infection control departments and there was a general lack of
awareness among doctors about the spread of drug-resistant infections,
he added.


"The responsible authorities should only allow the use of antibiotics
by qualified people" and proper monitoring of infections be carried
out, as antibiotic-resistant infections are increasing, he said.

© Copyright (c) AFP

•Comments (3)

An electron microscope is seen in a laboratory. Indian doctors
warned earlier this year about the threat from a new multi-drug
resistant 'superbug' -- months before a British study that New Delhi
has condemned for scaremongering.
Photograph by: Eric Piermont, AFP/Getty Images

Another confirmed Canadian case of a new superbug has health
officials here and abroad on alert. Global National's Crystal
Goomansingh reports.

Health Video Galleries » More Health Videos »

3 comments


doublepointedprincess 1:24 PM on August 13, 2010

WHAT ARE THE SYMPTOMS AND HOW DO WE KNOW IF WE MAY HAVE IT?
FAIL ON THE REPORTING!!!

Bratwurst 12:57 PM on August 13, 2010

Herry69; you are obviously a deep-thinking person.

Herry69 11:54 AM on August 13, 2010

This comment is hidden because you have chosen to ignore Herry69. Show
DetailsHide Details

...and what did they do about it besides nothing. picking their arse
im sure.


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