The Telegraph
Since 1st March, 1999
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Deadly bug defying antibiotics pops up

New Delhi, Dec. 10: A bacteria displaying resistance to virtually all antibiotics known to humans has surfaced in India, sending ripples of alarm among medical researchers who have called for nationwide surveillance and steps to stem its emergence.

Doctors at the Banaras Hindu University Institute of Medical Sciences in Varanasi detected the “superbugs” among strains of staphylococcus aureus — a bacteria often found on skin and in nostrils of healthy people, but which can also occasionally cause life-threatening infections such as pneumonia and septicaemia.

Among 783 samples of staphylococcus aureus picked up from blood, pus, urine, spinal fluid, sputum, and wound swabs from patients, the doctors found two that were resistant to vancomycin, the drug of last resort in the arsenal of conventional antibiotics.

“This may be the price of indiscriminate use of antibiotics which is widespread across the country,” said Malay Ranjan Sen, professor of microbiology at the Institute of Medical Sciences, who was in the team that isolated what is being described as the first vancomycin-resistant staphylococcus aureus (VRSA) strains from India.

Staphylococcus aureus is notorious in its ability to defy antibiotics. Strains of this bacteria found in hospitals in recent years have become increasingly resistant to most known antibiotics. Some are resistant to all but vancomycin.

Patients in hospitals, particularly those in intensive care units or recovering from surgery or with large wounds, are vulnerable to infection by staphylococcus. The Varanasi doctors have reported the emergence of VRSA in India in the journal BMC Infectious Diseases.

Sen said the two patients who were not responding to vancomycin therapy were very sick and died from complications of their illness.

“If this turns out to be true, it’s really alarming,” said Arti Kapil, additional professor of microbiology at AIIMS. “For patients infected with VRSA, there are almost no therapeutic options,” Kapil said.

Some doctors have cautioned that because VRSA is so rare, the Varanasi team should have — ideally — verified its findings from an independent laboratory.

US doctors had detected the first case of VRSA four years ago in a 40-year-old woman with diabetes, kidney disease and foot ulcers.

Three years ago, doctors at the Sher-i-Kashmir Institute of Medical Sciences in Srinagar had picked up the first signals that strains of staphylococcus in India may be displaying low levels of resistance to vancomycin.

Indiscriminate use of certain antibiotics on patients who may not really require them is one factor believed to be contributing to the emergence of drug-resistant bacteria. “The emergence of VRSA suggests that the abuse of antibiotics is occurring even in hospitals,” said Chandra Gulhati, editor of the Monthly Index of Medical Specialities, India.

The Varanasi doctors have suggested a nationwide surveillance programme to determine whether staphylococcus has become less susceptible to vancomycin in other parts of India.

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