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Both cases successfully contained as experts urge health officials to track deadly bacteria
A NEWLY found superbug from India that has been making news around the world infected two patients here early this year – before anyone knew what they were dealing with – but was successfully dealt with and contained.
The Ministry of Health (MOH) told The Straits Times that the patients had infections from bacteria with the New Delhi metallo-beta-lactamase-1 (NDM-1) gene identified last month.
The gene has the ability to shield bacteria from all antibiotics, turning them into drug-resistant superbugs.
It was found in the samples from the two patients last month, after hospitals went back and tested past samples.
“Following reports of NDM-1 in other countries and the availability of newer and more sensitive tests, our hospitals found two cases from the beginning of this year that were positive for NDM-1,” said an MOH spokesman.
One was a Singapore resident who had sought medical treatment in India, while the other had come to Singapore from Bangladesh for medical treatment.
They had been admitted at different times to the Singapore General Hospital. The patients were screened for drug resistant bacteria when they showed signs of illness besides the one they had gone in for – an indication they might also be infected with a superbug.
Both were quickly isolated from other patients after bacteria in their urine samples were found to be resistant to drugs. MOH said they were moved to singlebed rooms and had limited contact with visitors.
Health-care staff who attended to them also donned protective gear such as a gown and gloves at all times.
Both patients were discharged when subsequent urine tests showed no further growth of the bacteria, said MOH.
It is not known what other treatment they were given, but the ministry noted that strict hospital infection control measures are the key to fighting superbugs.
One measure is the retroactive testing of bacterial samples, following the discovery of a new mechanism for bacterial resistance.
Strains with unusual antibiotic resistance are stored for future study, said the MOH spokesman.
NDM-1 made the headlines after a study published on Aug 11 in The Lancet medical journal said the gene was detected in British patients in 2007, and appeared to have originated from India. So far, it has occurred mainly in two gut bacteria – Escherichia coli (E. coli) and Klebsiella pneumoniae.
The news triggered a global reaction as NDM-1 is able to resist even the most powerful class of antibiotics known as carbapenems.
Cases have now been reported in places such as the United States, France, Germany, Australia, Hong Kong and Japan. Last month, a Belgian man became the first known fatality.
On Monday, scientists at the Interscience Conference on Antimicrobial Agents and Chemotherapy urged the health authorities to track bacteria with the gene.
The conference in the United States, which ended yesterday, is the world’s largest gathering of infectious disease specialists, attracting about 12,000 people.
Drug-resistant superbugs are not new and include methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa.
MRSA is a serious infection found mostly in hospital settings, while the latter usually infects the lungs.
The NDM-1 gene is a part of a bigger problem of drug resistance brought about by the abuse of antibiotics worldwide.
To fight the spread of these bugs, local hospitals have comprehensive infection
control measures.
Hospital staff practise strict hand hygiene and are audited regularly.
Inpatients are also screened for existing superbugs such as MRSA.
There are also antibiotic stewardship programmes to help doctors prescribe the right type and dosage of antibiotics to minimise the rise of drug resistance.
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