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A new superbug that appears resistant to even the strongest of antibiotics has emerged in India and soon could spread worldwide, according to an article published Wednesday in The Lancet medical journal.

British scientists have discovered NDM-1, or New Delhi metallo-beta-lactamase 1, in 180 people in India, Pakistan and the U.K. Of those, 37 were patients who had returned to the U.K. after recently undergoing surgery in India or Pakistan.

NDM-1 alters bacteria, allowing them to flourish even in the presence of nearly all known antibiotics. It has been seen largely in E. coli bacteria, the most common cause of urinary tract infections, and on DNA structures that can be easily copied and passed onto other types of bacteria. It can lead to fatal pneumonia and other infections.

NDM-1 cases discovered:

United Kingdom: 37

Chennai, India: 44

Haryana, India: 26

Other sites in India and Pakistan: 73

TOTAL: 180

Source: The Lancet

"The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed," the article reported.

"The spread of these multi-resistant bacteria merits very close monitoring," wrote Johann Pitout, of the division of microbiology at the University of Calgary, in an accompanying commentary.

Pitout called for international surveillance of the bacteria, particularly in countries that actively promote medical tourism. "The consequences will be serious if family doctors have to treat infections caused by these multi-resistant bacteria on a daily basis."
U.K. issues alert

The U.K. Health Protection Agency has issued an alert about the superbug, forcing doctors there to report all suspected cases.

"The threat comes from the fact that these bacteria are so resistant," said Dr. David Livermore, an agency spokesman and one of the authors of the report.

"Nowadays we have five or six good antibiotics that are active in more or less all infections," said Livermore, who specializes in infectious diseases. "Here we're down to one or two not-very-good, rather old antibiotics."

The researchers said the superbug appeared to be already circulating widely in India, where the health system is much less likely to identify its presence or have adequate antibiotics to treat patients.

Aside from the U.K., the resistant gene has also been detected in Australia, Canada, the Netherlands, the U.S. and Sweden. The researchers said that since many Americans and Europeans travel to India and Pakistan for elective procedures like cosmetic surgery, it was likely the superbug would spread worldwide.