More public health doom and gloom from the infectious disease world – multiple bacterial found carrying stable and transmissible plasmids for the NDM-1 gene, a form of beta-lactamase that endows bacteria with carbapenem resistance. In the sewage. And in the drinking water.
…but only South Asia, for the time being. But, they also note that India is a popular destination for “medical tourism” to save money on surgical procedures, and patients have returned as carriers for bacteria with the NDM-1 gene.
This is not a unique development – there’s MDR tuberculosis, inducible clindamycin resistance for MRSA, and, my favorite, macrolide-resistant streptococcus. Macrolide resistance in streptococcus can be directly linked to the overuse of azithromycin, a patient-friendly drug with terrible pharmacokinetics. In contrast to the medication it replaces, erythromycin, it has such a long half-life (68 hours when multiple doses are administered) after you take your fifth dose that it spends a long period in the body below its therapeutic concentration, just sitting there as substrate to induce resistance without bacteriostatic properties.
Grim.