The new medical challenge: why NDM-1? Why Indian?

Promiscuous plasmids and genetic fluidity aside, the unbridled and indiscriminate use of antibiotics, lack of infection control policies and an inadequate national surveillance system have added to the spread of New Delhi metallo-β-lactamase-1 (NDM-1). Notwithstanding, as NDM-1 bacteria are mainly spread via the fecal–oral route, the dissemination of NDM-1 in the Indian community is highly likely and, therefore, inadequate sewage systems, which are often present in these countries, only further exacerbates the problem. Accordingly, the solution requires holistic actions and a change of social priorities which, if invoked, will almost certainly be too late to save one of medicine’s precious and long-standing resources: antibiotics...