Only a couple of days ago we were greeted with the good news by WHO that the  H1N1  pandemic flu alert  is finally over. However, the news of a recent research findings of a ‘superbug’ that can produce an enzyme called  NDM-1 (New Delhi metallo-beta-lactamse) which can resist even the most powerful antimicrobial agents has somewhat dampened the spirit.

The fact that the NDM-1 gene can exist inside  different species of bacteria including some of the common ones that  infect humans and animals such as E-coli, Klebsiella and Salmonella is indeed alarming.
 
What is more worrying and scary is the fears expressed by researchers that the NDM-1 could jump to other strains of bacteria which are already resistant to several other antibiotics. If this is true,  it could  trigger or cause dangerous infections in humans. The resistant bug could be easily transmitted from one person to another and it will be impossible to treat these infections.
 
Since there are already indications and evidence of the superbug been introduced in Western Europe, the US and Canadian experts are of the opinion that NDM-1 has all the potential to turn into another major global health problem.
 
In this context, I welcome the recent assurance by the director-general of health, Dr Ismail Merican, that the Health Ministry has already put in place a nationwide antibiotics surveillance  programme to monitor the changes in bacterial resistance

The DG's reminder to all clinicians to practice good antibiotic stewardship and to use antibiotics judiciously in accordance with local antibiotic guidelines is timely and should be taken seriously by all parties concerned including those in the agriculture sector.
 
The use and abuse of antibiotics in the agricultural sector especially in the livestock industry such as chicken, cattle, swine and goat farming, needs to be closely monitored too. The over- dependence and abuse of antibiotics in the livestock industry, especially by ignorant farmers, could pose a serious public health threat.
 
Antibiotic residues in meat including marine products and other edible farm products can cause medical complications apart from promoting wide spread antibiotics resistance. In view of the new NDM-1 threat, I urge the Agriculture Ministry to put in place appropriate preventive measures to ensure that the farm products do not end up in the open market loaded with antibiotic residues.
 
There is ample of scientific literature linking antibiotics residues in farm products (meat, fish and vegetables) to the spikes in antibiotics resistance in humans in many countries including Malaysia. As such, the authorities concerned should ensure that the supply and use of antibiotics in food animals is strictly monitored and regulated.
 
In view of the nightmarish scenario painted by some international experts with regards to this new superbug capabilities of spreading rapidly in the population, we cannot afford to be complacent.
 
On the other hand we should not  just push the whole responsibility of handling the threat to the health authorities only. The situation calls for a multilevel cooperation and expert input from other related authorities and agencies is a must to prevent the spread of this superbug - like how we managed the other health threats like the Nipah, Sars, H1N1 etc.
 
However this time around we may have to re-strategiae our preventive action plan against the onslaught of this NDM-1 threat. In view of the nature of this novel NDM-1 gene carrying bugs, it is not going to be easy to predict the outcome. As such the full cooperation and support of all  concerned parties for the health authorities is paramount in minimising the impact and effects of this superbug.