UK "medical tourists" travelling to India for treatment have returned as carriers of a lethal new mutant infection, experts have warned.
As many as 37 cases of infection with the mutation have been found in Britain so far, according to a report in The Lancet Infectious Diseases.
The NDM-1 gene was first identified last year and is widespread in bacteria called Enterobacteriaceae that are common in India and Pakistan.
The gene is said to make bacteria resistant to all antibiotics, with the exception of just two – tigecycline and colistin.
Researchers warned it could make antibiotics "redundant".
Researcher Dr David Livermore, director of antibiotic resistance monitoring of the Health Protection Agency, said: "The findings of this paper show that resistance to one of the major groups of antibiotics, the carbapenems, is widespread in India. This is important because carbapenems were often the last good antibiotics active against bacteria that already were resistant to more standard drugs.
"We have now also identified bacteria with this type of resistance – NDM – in around 50 patients in the UK. Most, not all, had previously travelled to the Indian subcontinent, and many had received hospital treatment there. International travel gives a great potential for spread of resistant bacteria between countries.
"Few antibiotics remain active against these bacteria. Their spread underscores the need for good infection control in hospitals both in the UK and overseas, and the need for new antibiotic development."
Writing in the same journal Johann Pitout, of Calgary University, Canada, calls for patients who have treatment in India to be screened before they are allowed into hospitals in their home country.
He says: "If this emerging public health threat is ignored, sooner or later the medical community could be confronted with carbapenem-resistant Enterobacteriaceae that cause common infections, resulting in treatment failures with substantial increases in health-care costs."
A spokesman for the UK department of health said: "The HPA alerted the NHS in January and July last year to be vigilant about these bacteria and take appropriate action where necessary.
"Hospitals need to ensure they continue to provide good infection control to prevent any spread, consider whether patients have recently been treated abroad and send samples to HPA for testing.
"So far there has only been a small number of cases in UK hospital patients."
The Lancet Infectious Diseases September 2010
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