(Guest Post: Written by A. Sri Mukesh)
India is now the host of a new disease which is capable of causing an epidemic. The disease is called CRE (Carbapenem Resistant Enterobacteriaceae). The term ‘Enterobacteriaceae’ refers to the family of bacteria that are present as pathogens.
Infections are often caused by the action of microbes. To control the infection, these microbes must either be killed or made dormant. Hence ‘antibiotics’ came into existence. The term was coined in 1942 by Selman Walksman and the first antibiotic to be discovered was Penicillin by Alexander Fleming in 1928. Amoxicillin and Cephalosporin are the other antibiotics that are commonly used all over the world. As the use of these antibiotics became rhetoric, the microbes developed resistance to these compounds. Hence ‘Carbapenem’ came into existence.
All the antibiotics including Carbapenem, have beta-lactam ring in their structure. The newly discovered Super-Bug releases a protein called NDM-1. ‘NDM’ refers to ‘New Delhi metallo beta-lactamase’. This protein in enzymatic in nature and as the name suggests, belongs to the class of ‘Beta-Lactamase’. NDM-1 dissolves the ‘beta-lactam’ ring of these antibiotics, thereby nullifying its action. Klebsiella was the first bacteria that was reported to contain NDM-1. MRSA (Methicillin Resistant Staphylococcus aureus) is another Super-Bug that is newly discovered. MRSA causes 19,000 deaths in USA every year as against AIDS which causes 17,000 deaths.
CRE, MRSA and VRE (Vancomycin Resistant Enterococcus) are the Super-Bugs that are rampant in all parts of the world. Super-Bugs usually are hospital acquired. But history shows that whatever actions we take, the disease somehow finds its way into the society. Britain has included Super-Bugs into its ‘National Risk Register’ (NRR). NRR is a document released by UK for the civilians and the organizations who would like to be better prepared for future emergencies. Rightly so, if the disease is not taken into serious consideration, it can cause an epidemic and no antibiotic whatsoever can curb its proliferation. Antibiotic resistant Super-Bugs would place us back into the 19th century where even minor infections can become potentially fatal.
The primary reason behind the formation of Super-Bug is rhetoric use of same antibiotics. Nature always finds new ways to survive. Hence the mutation in bacteria to produce NDM-1. Thus ‘new drug development’ is definitely what is required in the present scenario. From 1940-1960 almost 20 classes of drugs had been developed. But from 1960-2000 only 2 new classes of drugs were developed. The reason behind this is improper attention to ‘Research and Development’ (R&D).
Leading pharmaceutical manufacturers stress more upon formulating analogues for the older drugs rather than formulating new drugs as the enterprises are profit-driven and R&D might not always provide viable results. Due to the lack of accuracy in predicting the viability of the drugs, pharmaceutical manufacturers tend to give more importance to marketing old drugs rather than focusing on R&D. This is where the government should come into the picture and invest in R&D. Taxation of OTC (Over The Counter) antibiotics is a method that can check the super-bug by reducing the level of spontaneous mutations widespread in micro organisms (due to lesser degree of improper drug use). Synthetic Biotechnology also has a major role in acting against Super-Bugs.
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©The Idea Bucket, 2013. (Guest post, submitted by A. Sri Mukesh)