Sir Ganga Ram's surveillance for NDM-1 is a sign of a strong research facility
New data presented at the 1st Global Forum on Bacterial Infections in New Delhi this week showed that bacteria carrying the NDM-1 gene have been isolated in Sir Ganga Ram Hospital in New Delhi as well as in Kolkata. NDM-1, or New Delhi metallo-beta-lactamase-1, is a gene that confers a high level of resistance to antibiotics, and there are few to no treatments available for infections caused by bacteria that contain the NDM-1 gene.
These findings have set off a wave of concern about NDM-1 in the specific hospital locations where the study took place.
However, it is very likely that NDM-1 is widespread in most other secondary and tertiary hospitals as well. The only difference is that Sir Ganga Ram Hospital has a strong department of microbiology and a research culture that has allowed surveillance for NDM-1 in their facility. Their commitment to this study should be commended.
Rather than now pointing the finger at a single hospital, we should encourage others to look for and report NDM-1 as well. Surveillance data provides the foundation for successful infection control in hospitals. I would have no hesitation in being admitted to Sir Ganga Ram - instead, the strength of their surveillance system inspires confidence.
Further, we should keep in mind that NDM-1 did not appear out of thin air. Data show that the use of a powerful class of antibiotics called carbapenems has been steadily rising because of overuse and misuse, particularly in metropolitan areas. This abuse of antibiotics is largely responsible for the emergence of NDM-1, although it is not clear (or relevant) that NDM-1 first emerged in New Delhi.
Each of us has a responsibility to limit the spread of antibiotic resistance by not buying or using antibiotics without seeing a doctor. Conserving these drugs will help ensure that antibiotics will cure us if we are ever admitted to a hospital and acquire a bacterial infection. It will also save these valuable drugs for the millions of people living in remote parts of our country, including the 190000 newborns who die of sepsis each year because they do not have access to antibiotics. The responsibility for this shared resource is in our hands.




More about Dr Ramanan Laxminarayan
Dr Ramanan Laxminarayan is an economist and epidemiologist. He is Vice President of Research & Policy, Public Health Foundation of India, and Director, Center for Disease Dynamics, Economics & Policy.











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