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Mass. hunting for deadly NDM-1 cousin

BOSTON, Oct. 7 (UPI) -- Massachusetts hospitals will be surveyed to find out how many cases of a genetic cousin of a drug-resistant "superbug" are being treated, state officials said.

The survey, conducted by the Massachusetts Department of Public Health, will seek to gauge the incidence of Klebsiella pneumoniae, a deadly, drug-resistant bacterium that has been detected in 35 U.S. states, The Boston Globe reported.

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The rod-shaped Klebsiella bacterium is related to NDM-1, or New Delhi metallo-beta-lactamase, first identified in December 2009 in a patient hospitalized in New Delhi. The NDM-1 enzyme, which lets bacteria escape some of the strongest antibiotics, was later detected in bacteria in Pakistan, Britain, Belgium, the United States, Canada, Australia, Japan and Taiwan.

Like NDM-1, Klebsiella is highly resistant to some of the strongest antibiotics available, leaving doctors with few options when patients develop urinary tract, bloodstream or respiratory infections, the Globe reported.

"They're both really bad, and you don't want to get (them)," Dr. Helen Boucher, an infectious disease specialist at Tufts Medical Center, told the Globe.

But if Klebsiella remains in the intestinal tract, where it is naturally found, it typically causes no problems, doctors say.

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Its problems typically come about if it finds a way to escape the intestines, such as during surgery or some other medical treatment that causes incisions or requires invasive medical equipment to provide or remove fluids or sustain breathing, doctors say.

One of the two drugs doctors can use to combat Klebsiella is colistin -- but it was largely abandoned years ago because it was shown to be highly toxic to the kidneys and the nerves.

But, as a last resort, "if the person is really sick and they're not doing well, we end up having to do the colistin routine," Boucher told the Globe, "and we hold our breath."

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