BIOTERRORISM: NDM-1 in Toronto

August 21, 2010
Canada’s third case of a new antibiotic-resistant superbug has popped up in a Brampton hospital (Toronto suburb).
But the ministry of health and long-term care is insisting that the NDM-1 bacteria found at William Osler Health Centre is not cause for concern for people inside, or outside, of the hospital.
“The emergence of this is not unexpected at all,” said ministry spokesperson Joanne Woodward Fraser, adding that health officials in Ontario have been on the lookout since the first two Canadian cases appeared earlier this summer in Alberta and British Columbia.
Doctors worldwide are suggesting that the only known risk of getting a NDM-1 bacterial infection is by being treated in a hospital in South Asia, specifically Pakistan and India, where there have been more than one hundred reported cases.
“With the amount of travel that happens throughout the world, it was just a matter of time before it showed up here,” Woodward Fraser said.
The incident in Brampton occurred this past week when a patient, who had been treated in India recently, checked in due to an illness. When lab results came to the doctors, they confirmed the patient was infected with NDM-1 bacteria.
The patient was treated with antibiotics and has since made a full recovery, said Woodward Fraser.
But it is unclear if the treatment actually helped cure the patient.
NDM-1 — the medical nomenclature for New Delhi metallo-beta-lactamase — is an enzyme, which has been found in many bacteria, such as e. coli. If inside a bacterium, it will block the effectiveness of antibiotic treatments.
The symptoms of being infected with NDM-1 bacteria depend on the type of bacteria the enzyme has developed in. But many common infections can be associated with these infections, including uncomfortable but nondeadly urinary tract infections to serious, life-threatening blood infections.
Dr. Dylan Pillai, a medical microbiologist with the Ontario Agency for Health Protection and Promotion, has been studying evolution and movement of NDM-1 since it was first discovered in New Delhi a few years ago. He says that the enzyme’s appearance is likely linked to patterns of antibiotic usage. The problem stems from certain areas overusing antibiotics, prompting bacteria to evolve and produce resistant enzymes like NDM-1.
Some people infected with the bacteria can be treated by a cocktail of antibiotics, but for others the infection will simply run its course and disappear, said Pillai. Either way, people concerned they been infected should consult a doctor.
Despite the bacteria’s resistance to treatment, neither Pillai nor Woodward Fraser is concerned that Brampton’s case spread in the GTA. The Brampton hospital has followed its standard infectious disease control protocol, which involves disinfect all staff and equipment, said Woodward Fraser.
Keeping clean is also the best defence for people outside of hospitals who are worried about the superbug.
“Simple things like hand washing are really the best way to stop these things from spreading,” said Pillai.
http://www.healthzone.ca/health/newsfeatures/article/850906--superbug-detected-in-gta