Hong Kong has right conditions for outbreaks of drug-resistant superbugs

In August, Princess Margaret Hospital reported the second case of the New Delhi metallo-beta-lactamase (NDM-1) Enterobacteriaceae, a lengthy name for a microbe that can simply be called a superbug.

NDM-1 Enterobacteriaceae refers to a family of gram-negative bacteria that are resistant to almost all available antibiotics. Metallo-beta-lactamase is an enzyme produced by these bacteria that negates the effects of virtually all known antibiotics, including carbapenems, a class of antibiotics generally regarded as the last resort for this sort of infection. In essence, these bacteria are virtually indestructible.

They were first identified in 2008 in a Swedish tourist who fell ill in the Indian capital. By March this year, the US Centres for Disease Control (CDC) had reported 13 cases in the United States. The medical literature is now replete with case reports from around the world, including the UK, Canada and Japan. Hospitals, infectious disease centres and doctors have since been placed on alert and drug research switched into high gear to make preparations should an outbreak occur.

On a micro level, the gene for NDM-1 is found on the DNA strands called plasmids within the bacteria, which can easily be transferred from one strain of bacteria to another. Gram-negative bacteria can be the cause of almost any infection ranging from wounds to those of the urinary tract, lungs, gastrointestinal tract and central nervous system.

Thus, transmission can occur from fluids from any of these organ systems. The clinical symptoms can range from being completely asymptomatic to full-blown infection leading to overwhelming sepsis, a medical condition characterised by inflammation of the body against a pathogen.

On a community level, spread of the superbug is boosted by overpopulation, a humid climate, and most importantly, indiscriminate use of antibiotics. As a travel hub. Hong Kong is at risk.