Not yet an era where people can travel quickly and conveniently like today. 3.77 billion air travel passengers are worldwide figures in 2016. But here, we will not mention the potential of the tourism industry. The downside of moving too conveniently is that dangerous pathogens are also spreading across the planet, with dizzying speed.
The most recent case warning of this problem is an American woman. She died in a special isolation ward in a Navada state hospital, when the bacteria that caused the infection were resistant to all existing American antibiotics. It is worth mentioning that this strain of bacteria is extremely rare in the United States. The woman had infected it after she returned from India.
Many similar death scenarios have been reported before, scattered in North America, Europe and Australia. What has happened in India for more than a decade, making tourists return from this South Asian country, at an extremely high risk of dangerous antibiotic-resistant infections?
"A lot of research shows that: to India you are putting yourself at high risk of infection , " said Ramanan Laxminarayan, director of New Delhi's Center for Disease Dynamics, Economics & Policy, an organization. Non-profit actively participates in the war with antibiotic resistance said.
The possibility that Indian viruses have infected tourists, through food and water. After that, they hide and hide between intestinal microorganisms. Once there is a chance, the virus carrying the resistant gene will escape from the intestine, enter the blood or bladder to cause infection.
In many cases it is an infection that cannot be treated, regardless of any antibiotic.
In fact, India is burdened with a huge medical burden from antibiotic resistant viruses. Particularly resistant blood infections killed 58,000 babies in India, Laxminarayan said. Abuse of antibiotics, backward living conditions, poor hygiene and even lack of clean water has created a very favorable environment for mutant bacteria in India.
The national government is taking all tough measures to deal with it. In 2014, they even had to issue a ban on direct selling of antibiotics to people . Efforts to prevent people who are ignorant of buying antibiotics and abuse.
In the same year, Prime Minister Narendra Modi launched a program to abolish indiscriminate toileting in India. The campaign is scheduled for 5 years, and is part of a national program called "Clean India".
However, experts say India should act sooner. For a long time, antibiotic-resistant infections have been warned that the world will turn upside down.
Johann Pitout is a medical microbiologist at the University of Calgary, Canada. He was one of the first scientists to study the spread of drug-resistant bacteria, fueled by tourism. Having moved to study and work at the University of Calgary since 2002, the once-trained South African doctor found that not only in the hospital environment, antibiotic-resistant bacteria are also spreading rapidly. outside the community.
In this context, he was particularly interested in the type of intestinal bacteria carrying a special enzyme called ESBL . They are resistant to many antibiotics such as penicillon and cephalosporin.
"ESBL mostly appears and spreads in the community environment, which was the first time I discovered that," Pitout said in an interview. So he began to examine patients to find out why. The answer finally shows up behind their travel records. "Most of the patients had previously been to India and China," he said.
India's travel and airline destinations continue to be expected to grow strongly in the future. However, scientists also warn of the risk of development in parallel with it. At least eight studies by Australian scientists show that tourists returning from India, in addition to souvenirs, are highly likely to carry both resistant ESBL-producing bacteria in the intestinal tract.
From another study in Sweden, scientists tested rectal specimens of 105 tourists returning from many countries around the world. Before their trip, there was only one case of drug-resistant E. coli infection.
But after returning, up to 24 people brought bacteria containing ESBL enzymes to Sweden. There are 8 people who choose their destination India, up to 7 people return to drug-resistant viruses in the gastrointestinal tract.
Once located in the intestinal tract, the viruses can move to many other parts to cause a hard-to-treat infection, such as the urinary tract. They also pose a high risk for men who undergo prostate biopsy, or anyone who has had gastrointestinal or gallbladder surgery, Peter Collignon, World Health Organization adviser on resistance. antibiotics said.
Patients hospitalized with invasive infections with the ESBL virus are usually treated with a carbapenem antibiotic. It is one of the last medicines for the last case, when most other antibiotics have been disabled by bacteria.
However, even now carbapenem antibiotics have been neutralized by bacteria, with drug-resistant enzymes that they evolve and secrete. In many cases, the bacteria resistant to all types of antibiotics have appeared. They carry a resistance gene, first discovered in China, but have now spread to more than 20 countries.
Lindsay Grayson, Head of Infectious Diseases at Austin Hospital, Australia, said: Antibiotic resistance is becoming an increasingly urgent problem on the world. But a particularly high rate of antibiotic resistance will be found in South Asia, Southeast Asia, China and some parts of southern Europe like Greece.
"The extent of the spread of these microorganisms and the extent of the problem is still being determined, " Gayson said in a telephone interview, while he is still in Geneva to assist WHO in building a prize. solution to the problem. "In Australia, we have started to worry more about people who have traveled."
For example, Gayson refers to a new man returning from China. Unfortunately, he had to undergo a medical treatment. Doctors will have to be screened very carefully, to see if a man brought back from China a dangerous drug-resistant bacterium. Because if there is, a high risk it will affect the quality of surgery and leave many risks in his life later.
The strain of bacteria that killed American women, it is resistant to a total of 26 antibiotics that the US hospital currently has. The reason comes from a deadly gene that bacteria carry within themselves.
Called NDM for short, this gene has the full name New Delhi metallo-beta-lactamase . As you can see, it calls out the name of the capital of India to commemorate the origin discovered by scientists.
However, until now, NDM has been found all over the world. Most recently in the United States, when the woman in Nevada was accidentally infected, then brought NDM back from a time to live and treat in India.
The name New Delhi metallo-beta-lactamase must still be topical, as the city is still a source of dangerous antibiotic-resistant bacteria, Laxminarayan said." Carbapenem antibiotic resistance is rife in India - both in hospitals and in the community".