Open AccessIs NDM-1 actually being imported to UK from India?
Author(s) -
Shashi Kant,
Partha Haldar
Publication year - 2010
Publication title -
indian journal of public health/indian journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 26
eISSN - 2229-7693
pISSN - 0019-557X
DOI - 10.4103/0019-557x.75738
Subject(s) - public health , epidemiology , new delhi , medicine , environmental health , pathology , metropolitan area
A recent article in Lancet Infectious Diseases suggested that Enterobacteriaceae containing New Delhi metallo-βlactamase (NDM-1) gene were being imported into UK from India. Since the study findings had widespread public health implications, it was necessary to scrutinise the adequacy of the evidence. The article was critically appraised on epidemiological, biological, and molecular evidence, the ethical principle of research, potential conflict of interest, and the justifiability of the recommendations. The study design was inappropriate to establish a causal chain between hospitalization in India and importation of NDM-1 in UK. Out of the total 29 NDM-1 positive UK patients, the NDM-1 gene was present in equal proportion among those who were hospitalized in India (44.3%) and those who were not (51.7%). Statistically significant strain relatedness between Indian and UK isolates could not be proved through dendrogram. There was a potential conflict of interest that was not disclosed. We found that the study findings did not support the authors' conclusion that India was a source for NDM-1 positive UK patients. Misplaced conclusions had the potential to cause unfounded scare and panic.