NDM-1 Do not panic before the super germ

Are the multi-drug resistant NDM-1 bacteria actually as dangerous as many report? Many scientists give the all-clear and warn against unnecessary panic.

(21.08.2010) The new multi-resistant germ NDM-1 has now arrived in Europe. Numerous media reports spread an unnecessary panic that unsettles people. The reason for the uncertainty of many people was a medical report in the magazine "Lancet". Here, an international team of researchers reported that no antibiotics and no conventional reserve antibiotics were effective against the new "super germ". The germ NDM-1 is therefore multi-resistant. The scientists warned against a possible worldwide spread of mutant bacteria.

Germs that carry the gene NDM-1 have been detected mainly in India and Pakistan. There, the bacterial strains spread not only in hospitals, but are now also transmitted from person to person. The germs with the NDM-1 pathogen have also been detected in recent weeks in patients in various European countries, including the United Kingdom and Germany. But according to the Robert Koch Institute (RKI) just 4 people in Germany are ill. Thus, such gene-mutated bacteria occur extremely rarely. Nevertheless, the institute points out that new bacterial strains can spread quickly and everywhere due to the worldwide travel traffic.

What is special about the so-called super germs? The bacteria have an altered gene called "NDM-1" in the medical community. The gene comes i.a. in bacterial strains such as Escherichia coli and Klebsiella pneumoniae. The germ is not a new microbe but a gene. These two microbes settle in the human intestinal flora and in the lungs. So far, it was the case that in antibiotic resistance of the germs mostly reserve antibiotics such as carbapenems achieved a therapeutic success. But reserve antibiotics can not help with the mutant bacterial strains with the gene NDM-1. They are now multi-resistant.

But do people now have to worry about their health or is there a panic? Physicians and researchers estimate the risk to the population in Germany as very low to insignificant. Because it is completely normal for bacteria to settle in the human organism. That explained u.a. also the "National Reference Center (NRZ) for Gram-negative pathogens". Bacteria now settle in the human body, through the colonization is far from causing any disease. It depends on the structure of the microbes. Only certain types and variants trigger a disease and may pose a risk to health. So it may be that you already have intestinal bacteria in it, which are genetically modified and mutated by the NDM-1. But a disease is not triggered, the human does not notice that such bacteria have settled in the intestine. Many bacteria are rather harmless in nature and can not harm humans. Another important aspect is the general health condition. People with chronic illnesses, elderly patients with a weakened immune system are more at risk than people with a healthy, stable condition.

So far it has been reported incorrectly that no drug is effective at all. The scientists reported in the journal "Lancet" that the NDM-1 bacteria jumped on reserve antibiotics "tigecycline" and "colistin" and could be effectively controlled. However, these very strong antibiotics have strong and numerous side effects compared to the conventional preparations.

But are such multiresistant bacteria that have such mutations in the genes actually new? Not at all. Because multidrug-resistant bacteria, so-called MRSA germs, have also been observed in Germany's hospitals for a long time. The most common and serious complications are caused by MRSA bacterial strains (multi-resistant Staphylococcus aureus). These MRSA bacteria are also resistant to antibiotics and are produced where most antibiotics are used - in hospitals. They lead to skin diseases, severe inflammation of the heart, pneumonia and blood poisoning.

According to the National Reference Center (NRZ) for Gram-negative pathogens, NDM-1 gene-mutated germs are not the first to be immune to the reserve antibiotic carpabenem. It is still unclear whether the new variant is more resistant than the previously known pathogens.

Can people effectively protect themselves from infection? Then as now, his hands should be washed regularly. Especially in clinics and hospitals, patients, doctors and hospital staff should pay attention to hygiene and wash and disinfect their hands several times a day. But even at home, the hands should be washed especially after de contact with other people. But even here, a healthy measure applies. Washing hands constantly and avoiding social contacts is more than exaggerated.

However, the emergence of antibiotic resistance is also due to the use of detergents, the so-called „quaternary“ Containing ammonium compounds (QAC) with disinfecting effect favors. Because the same genes of the bacteria, which provide the QAV resistance, also give them the resistance to antibiotics.

Will there be effective drugs in the future? At the moment, it does not look as if pharmaceutical manufacturers have developed new active ingredients. For in the last 10 years hardly anything has changed in this field. The main reason for this is that the pharmaceutical companies have hardly invested in the research of new antibiotics, because simply can not earn enough money. This is also confirmed by the microbiologist and antibiotics expert at the University of Tübingen, Wolfgang Wohlleben. The pharmaceutical companies have hardly made any effort in the past to develop effective antibiotics. "That's very problematic because development time and research are very time-consuming and time-consuming". It may take between 10 and 20 years for a new drug to be developed. The expert points out that reserve antibiotics may only be used in an emergency to avoid new resistance in the genes of the bacteria.

If you have been infected with a pathogen, so it is also extremely important to actually take the antibiotic drug until the end and according to medical instructions. Because if the medications are discontinued in between, before the therapy is over, a resistance can form. One reason for the spread of the NDM-1 pathogen is that patients in India can buy antibiotics without a prescription at pharmacies. Many take the remedies only to symptom reduction, the bacteria were not completely defeated. This resulted in a resistance of the bacterial strains. (sb, gr)

Also read:
The new super germ NDM-1
Resistant bacteria in German hospitals
Risk of infection in the hospital

Picture: Dr. Karl HERRMANN