M A I N   N E W S

India trashes Superbug report
Says nation’s hospitals safe, to lodge protest with Lancet
Aditi Tandon
Tribune News Service

Research market-driven? Study funded by the EU, pharma firms Wellcome Trust and Wyeth. Both produce antibiotics used post-surgery. Its lead author received a travel grant from Wyeth Its co-author got conference support from many pharma companies and holds their shares. Sample draws inferences from positive cases referred to British labs, no info on sample size.

New Delhi, August 12
The government and health experts today slammed a new online Lancet study attributing to India the emergence of an antibiotic-resistant superbug.

Reacting to the naming of the said enzyme as New Delhi Metallo beta lactamase, the Health Ministry said that the government would register an objection with Lancet. A Health Ministry spokesman said that the study lacked scientific data to support its “frightening anti-India conclusions” and that some of its authors had declared conflict of interest.

Titled ‘Emergence of a New Antibiotic Resistance Mechanism in India, Pakistan and the UK’, the study created a sensation as its authors -- including one from UK’s Cardiff University -- claimed that the Indian superbug could threaten patients worldwide.

The research was funded by the European Union and pharmaceutical companies Wellcome Trust and Wyeth, both of whom produce antibiotics for treatment of cases in question. Details with The Tribune reveal that the study’s lead author Karthikeyan Kumaraswamy received a travel grant from Wyeth. Another author David M. Livemor got conference support from many pharma firms and holds shares in AstraZenecea, Merek, Pfizer, Dechra and GlaxoSmithKline (GSK). As attorney, Livemor manages further holdings in GSK. The government said the research appeared market-driven and didn’t conform to the code of medical ethics. “When authors have conflict of interest, their study is not analysed under protocols meant to analyse genuine research for patient care,” Director General Health Services Dr RK Srivastav told The Tribune.

He said conclusions of the study were loaded with an inference that the resistance organisms originated in India and it wouldn’t be safe for UK patients to opt for surgery here. “Indian hospitals and medical tourism are safe,” he insisted. The statement followed hectic consultations with 15 top experts from the Indian Council for Medical Research (ICMR), National Centre for Disease Control, AIIMS, Apollo and WHO Country Office, among others.

Ironically, the study analyses reveals that of the 3,500 bacterial cultures done, only 4 per cent had the resistant bug. Of these, just 1 per cent developed resistance due to the ‘New Delhi’ enzyme.

“Of all drug resistance cases in the study, 44 per cent are attributed to the Indian bug. The authors are silent on the remaining 56 per cent. That source could be anywhere, even in UK. Although the study targets cosmetic surgery, of the 44 per cent resistant cases it traces to India, only 1 person underwent cosmetic surgery,” Dr Rakesh Khazanchi, Director, Cosmetic Surgery, Vedanta Medicity told TNS, saying the study targetted Indian medical practice.

Medical experts also pointed out that the sample on which the study under question was based is biased as it draws its inferences on the basis of positive cases referred to British labs. “There would be thousands of patients who would have travelled through India and undergone procedures without any infections or resistance. We don’t know the size of the pool from which the sample was sourced. The entire tested sample was positive,” Dr Khazanchi added.

Among the strains studied, 44 were isolated in Government Medical College-Chennai, 26 in Government Medical College-Rohtak, 37 in the UK and 73 in India and Pakistan. Though it reports the presence of a plasmid associated with drug resistance to several antibiotics -- including Carbopenems (third generation antibiotics) -- such plasmids have been present in bacteria for decades, ICMR head Dr VM Katoch argued. The government said that the study should have highlighted that getting infection by drug-resistant bacteria was a matter of chance, a global phenomenon and preventable by sound infection prevention strategies.

A national resistance alert was issued in July 2009 in UK. Similar plasmids have been reported from Israel, the US and Greece.