Superbug scaremogering: It’s not the end of antibiotics (Comment)

After the swine flu, or the Influenza A H1N1, virus achieved media superstardom in the past 12 months before bowing out of the world stage unceremoniously last week, its place has been taken by a new superstar.

A new gene, New Delhi metallo-beta-lactamase or NDM-1 found in gut bacteria in patients treated in some Indian hospitals is alleged to be the new sensation.

A routine scientific paper to appear in science journal Lancet by an international team of researchers including a Briton and an Indian, is the cause of regional alarm. The bacterial gene, found in one to three percent of patients with enterobacteriaceau infections in India, has reportedly become resistant to all known antibiotics.

This has led to a flurry of media articles with titles like, “The End of Antibiotics,” and global scare that the human race has run out of options to treat “superbugs” such as NMD-1 and a doomsday scenario that awaits us. More importantly, the thrust of these articles is that patients who undergo medical treatments in India are prone to be infected by this “superbug”.

More than 82 years ago, Alexander Fleming, made the chance discovery of antibiotics and penicillin became the wonder drug in the next few decades. In the six decades, medical researchers developed a wide range of antibiotics to treat as many infectious diseases as possible.

However, in the past two decades, many scientists and commentators have started to write premature obituaries of antibiotics. In fact, the latest headlines in newspapers based on the NMD-1 reports have a common theme: “Is it the end of antibiotics?”

But is it really so?

What is happening today seems to be an exact replica of the events over 16 years ago. In March 1994, Newsweek magazine ran a report, “The End of Antibiotics?” by Sharon Begley. The reference was to the discussions at the annual meeting of the Association of Advancement of Science in San Francisco that concluded n February 1994.

“We are facing nothing short of a medical disaster,” the article quoted microbiologist Alexander Tomasz of Rockefeller University as saying at the conference, warning that “many common bacteria are evolving resistance to more and more antibiotics.”

What was the trigger? The data for 1992 indicated that resistant infections killed 19,000 patients in hospitals in the US that year and contributed to the death 58,000 more outside.

What happened then? In 2005, more than two million people in the US were affected by infections and 90,000 of them died. In the UK, there were 300,000 infected patients with 5,000 deaths, according to information compiled by science writer Thomas Hausler in his book, “Viruses vs Superbugs.” The book was published in German in 2006.

Even after 16 years, antibiotics continue to thrive even though more resistance has been reported regularly. So will the August 2010 obituary on antibiotics also be another such premature exercise?

A majority of hospital infections are caused by the Staphylococcus aureus bacteria. In fact, Dr. Tomasz has found that 70 percent of the known 3,000 strains of this bacteria found all over the world belonged to just five strains. What this means is that it doesn’t matter where the bacteria found first.

The source is not so important. These tiny microbes have always had a way in spreading themselves to all parts of our Planet. So blaming a particular city, hospital or country does not help the cause of finding a quick cure.

It is true most of the pharmaceutical companies have given up their development efforts on new antibiotics due to low margins. If antibiotics resistance becomes widespread, definitely human ingenuity will once again ensure that enabling environment is provided to the experts to find the necessary cure.

Phage therapy is one of the most promising cures around the corner. Phages, the viruses that kill harmful bacteria, is one such cure and the numerous research groups that are working quietly in the background will get the fillip soon, just like the lease of life that biofuels got due to the alarming price increase in fossil fuels.

It is certainly not the end of antibiotics. And NMD-1 will not be an antibiotics killer, anyway.

(15-08-2010- Narayanan Suresh is group editor of BioSpectrum and Technology Review India. He can be reached at sureshn@cybermedia.co.in)