Antibiotic-resistant enterobacteria are being spread in sewage systems in India. NDM-1 producing bacteria were found in water supply and sewage seepage samples in New Delhi in a study from May 2011 in The Lancet (attached).


NDM-1 stands for New Delhi metallo-beta-lactamase. This is an enzyme that has recently been discovered in enterobacteria (such as E-coli, Klebsiella, Shigella, Proteus, Enterobacter, etc. These are mainly gram-negative bacteria which means the membranes of these bacteria are less sensitive to antibiotics to start with. What is serious about NDM-1 is that this enzyme mutation renders these bacteria insensitive to commonly available antibiotics. Cases have been detected in India, Pakistan, the UK and other locations. See attached the breakthrough article in the Lancet from 2010.


What I find somewhat alarming is that this is being dealt with almost entirely as a medical problem centering on improper use of antibiotics. And the first line solutions remain to be more sophisticated antibiotics. But these are not forthcoming and probably won't be for at least 10 years, if ever. An integrated preventative approach involving water, sanitation and hygiene experts and practitioners has still yet to be initiated. Containment of faeces and reduction of associated pathogens should be the top priority for all cities at risk. Waterborne sanitation systems were never designed to eliminate these sorts of superbacteria and now that they are even turning up in the chlorinated water supply system we can see what sort of monster this can develop into.

News this month from Hongkong indicate that mainland China is now a source of these mutated E. coli as well. www.scmp.com/news/hong-kong/article/1084...e-fourfold-hong-kong

For more reading see the additional 2 attachments.



Arno Rosemarin/SEI