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A new gene which turns bacteria into powerful drug-resistant strains has landed in Singapore. Here is how you can protect yourself. POON CHIAN HUI reports
 A new superbug gene, as yet unnamed, landed in Singapore at the beginning of this year, long before it hit headlines around the world.
But its visit was discovered only last month, when the Ministry of Health (MOH) tested past bacteria samples of patients after it got a name – New Delhi metallo-betalactamase-1 (NDM-1).
As reported in The Straits Times yesterday, the NDM-1 gene sneaked into Singapore with two people flying in from India and Bangladesh.
This new strain, like the existing methicillin-resistant Staphylococcus aureus (MRSA), has the ability to turn bacteria into superbugs that are resistant to powerful antibiotics.
While this episode underlined the airtight hospital infection control measures here, the public should not let their guard down.
Superbugs may not always be confined to sick people in hospitals, said Associate Professor Raymond Lin, the head of National University Hospital’s (NUH) microbiology department.
“Antibiotic-resistant bacteria tend to affect people who are seriously ill or are taking antibiotics for a prolonged period. But with time, some of these bacteria can also affect healthy people, both in the hospital and in the community,” he said.
Hence, the public should stay alert – starting from observing good hand hygiene while visiting friends or relatives in hospitals.
For instance, one should clean his hands with alcohol hand rubs before touching a patient, said Dr Ling Moi Lim, the director of infection control at Singapore General Hospital (SGH).
“For this purpose, alcohol rubs are placed at the foot of every bed, along corridors, at lift landings and near eateries so that they are freely accessible to both staff and visitors,” she said.
Meanwhile, avoid asking for antibiotics from doctors unnecessarily, added Prof Lin. This is because excessive and improper antibiotic use can accelerate the spread of drug-resistant superbugs.
“Also, don’t remain in the hospital if you are fit for discharge – this minimises the risk of an infection,” he added.
As for the two NDM-1 cases here, both patients were isolated from other inpatients at SGH and were later discharged without incident.
Hence, hospitals also play a vital role in stemming the spread of superbugs. Tan Tock Seng Hospital, for one, took to the streets last year to raise public awareness about proper hand hygiene.
Public handwashing demonstrations of the seven-step handwashing technique were held in popular shopping malls like United Square from last April to August.
Hospitals here have also rolled out antibiotic stewardship programmes which monitor the prescription and proper use of antibiotics in order to slow the spread of drug-resistant bugs.
Associate Professor Dale Fisher of NUH, explaining how such a programme works, said that hospital pharmacists would visit the wards to check if the prescribed antibiotics are used appropriately.
“If a flag is raised, they will consult the infectious diseases specialist – for example, if a patient is given a broad-based antibiotic, the doctor may offer another antibiotic that targets a narrower spectrum of bacteria,” said the professor who heads NUH’s infectious diseases division.
Regular audits, or inspections, are also carried out to ensure that medical personnel stick with infection control measures such as hand hygiene and the use of hospital gowns and gloves, said Dr Ling.
Inpatients are also screened for the existing superbug, MRSA, a multi-drug resistant bacteria that has been around since the 1980s. It can be treated with certain types of antibiotics.
Many MRSA infections occur in hospital inpatients – those with a weakened immunity and those with open wounds are more vulnerable to the bacteria.
Prof Fisher said almost all adult inpatients at the hospital are screened for MRSA.
Patients found to carry the bacteria will be isolated from the rest, he added. MRSA screening involves taking swabs from the patient’s nose, groin, armpit and wounds.
The new superbug gene, NDM-1, rose to prominence after a study published in The Lancet Medical Journal on Aug 11 first identified the gene and revealed that it infected 37 Britons who had medical treatment in South Asia. Later, it was found to have killed a Belgian man.
Such superbugs have existed globally for more than 50 years, after the first group of antibiotics, penicillin, was mass-produced in the 1940s.
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