Six months after angering India by naming a drug-resistant superbug after New Delhi, the three medical scientists who led the original study now say there is a possibility the strain may have also originated independently in Europe.
The British team offered the new “hypothesis” this week, after a surveillance study of 29 European countries, published in December 2010, showed that a small number of patients carrying the NDM-1 superbug may have contracted the bug in the Balkans. Countries in the region include Bosnia, Serbia, Kosovo and Montenegro.
Before the European study, it was assumed that the New Delhi metallo-beta-lactamase 1 superbug originated in the Indian subcontinent. In their paper published in the Lancet Infectious Diseases journal in August 2010, the authors even argued that British patients who wanted to get surgeries done in India ran the risk of contracting superbugs.
But the data from the European surveillance shows while most of the European patients with the superbug had been to the Indian subcontinent, a small number from Belgium, Denmark and Germany had not. They too had travelled — but to Balkan countries.
The authors have come up with two explanations for this anomaly in this month’s edition of Lancet Infectious Diseases. The first is that NDM-1 appeared “independently in both this region of southeastern Europe and the Indian subcontinent.”
Alternatively, they say, the NDM-1 enzyme could have been imported to the Balkans from Pakistan. They cited previous research that showed that “commercial kidney transplants” in Pakistan of patients from southeastern Europe were marked by poor outcomes and frequent infection.
“Medical tourism of this sort could have introduced NDM-1 to the Balkans,” the British scientists said.