The Indian government is up in arms about a Lancet Infectious Diseases paper (subscription required) that traces the movements of an insensitively named superbug.

The “New Delhi metallo-β-lactamase 1 (NDM-1) positive Enterobacteriaceae” comprise a new breed of multidrug-resistant bacterium. Germs carrying the NDM-1 gene fend off almost every known antibiotic, including the carbapenem family of drugs reserved as a last resort. One such bug claimed its first known fatality in June, when a Belgian man infected while hospitalized in Pakistan died in Brussels.

The Lancet paper found the NDM-1 gene in isolates of Escherichia coli and Klebsiella pneumoniae taken from sites in the United Kingdom, India, and Pakistan (see map). Of the 29 UK patients found with NDM-1 germs, 17 had recently traveled to India or Pakistan, and several had been hospitalized while undergoing elective surgery. The authors concluded that the NDM-1 superbugs were seasoned travelers that could pose a worldwide health threat, and ended the paper with a paragraph discussing the risks of medical tourism in India.

For the Indian government, the statements about medical tourism added insult to the injury already created by naming the NDM-1 enzyme after the country’s capital city. “After seeing the research paper I strongly refute that hospitals in India are the source of the strain and strongly condemn naming the bacteria after New Delhi,” said Director General of Health Services RK Srivastav (IBN). Health minister Ghulam Nabi Azad noted that several study authors had pharmaceutical ties (CBS), while politician S. S. Ahluwalia called the report a “sinister design” of foreign multinational companies to undermine India’s burgeoning medical tourism industry (Hindustantimes).

Figure reprinted from Kumarasamy, K. K. et al. The Lancet doi:10.1016/S1473-3099(10)70143-2 (2010). Copyright with permission from Elsevier.