The Centers for Disease Control (CDC) yesterday announced the nation’s first case of superbug NDM-1, but said quarantine would not be necessary, a decision that was strongly criticized by the former director of the agency.
Describing the Taiwanese man as a healthy, asymptomatic carrier, the CDC said the patient was recovering well and quarantine would not be required.
CDC Deputy Director-General Shih Wen-yi (施文儀) said the man was one of two Taiwanese wounded in New Delhi on Sept. 19, while working as part of a camera crew on a food documentary for a show on cable channel TVBS.
In the incident, two attackers on a motorbike opened fire outside New Delhi’s main mosque, shooting at a minibus hired by the crew.
CDC officials said the bacteria were found in the form of colonization in the patient’s intestinal tract, which meant that it was not a -category-four communicable disease. Although the man carries the bacteria, he shows no symptoms of the disease, nor does he need to be quarantined, officials said.
The victim’s anal swabs tested positive for the bacteria, but the superbug was not found in samples taken from his urine or gunshot wound, Shih said.
Shih said the infection was most likely a result of receiving surgery and medical treatment in the hospital in India, rather than an indigenous case. The NDM-1 superbug has not been found in the man’s travel companions.
The man, who was hospitalized at Taipei Veterans General Hospital on Monday last week, has now returned home.
CDC officials will follow up with check-ups on the man’s condition every week.
“The patient is recovering well [from the gunshot] and his daily activities are not affected,” Shih said. “Those living in his community need not worry about being infected by the bacteria.”
The CDC said it was still important to maintain good hygiene habits, and added that it had informed the WHO of this case.
The new strain of bacteria, named New Delhi metallo-beta--lactamase-1, is resistant to all known antibiotics and was listed as a category-four communicable disease by the Department of Health last month, meaning that hospitals and clinics must immediately report any suspected cases.
As NDM-1 is not an airborne disease, patients diagnosed with the bug do not need to be quarantined or kept in isolated hospital wards, though doctors must inform the health authorities about the cases, Shih said.
Doctors should notify the CDC or its local branches within 24 hours of seeing a patient who has received invasive surgery, has traveled abroad — to India and Pakistan in particular — over the past six months and whose samples show resistance to Carbapenem antibiotics.
Meanwhile, former CDC director Su Ih-jen (蘇益仁), who is now deputy superintendent at National Cheng Kung University Hospital, said the situation was serious and should have been dealt with differently.
The fact that the patient failed to exhibit any symptoms of infection such as diarrhea, indicating that the bacteria was non-toxic, was secondary to the potential for the drug-resistance of the introduced bacteria to be passed on to native bacteria in Taiwan, he said.
Su said that if the drug-resistant bacteria were present in sufficient quantities in the excreta of the patient, the resistant gene could be replicated in native bacteria such as intestinal bacteria. Native bacterial pathogens might then develop drug-resistance. If members of the public became infected by these, it would cause severe problems, as the resulting illnesses would be difficult to treat, he said.
Additional reporting by staff writer
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