An American woman in her 70s who contracted an infection while being treated for a thigh bone fracture in India two years ago died recently. Tests on her wound specimen at CDC Atlanta, which houses one of the world's most advanced laboratories, later confirmed the presence of New Delhi Metallo-Beta-Lactamase (NDM) -a superbug. Tests showed no drug available in the US would have cured the infection.The finding has jolted medical professionals who see it as a sign of a post-antibiotic era, triggered by, among other factors, pill popping for common conditions. CDC reports that the American woman was admitted several times in a hospital in India, the last visit being in June 2016. She returned to the US soon after and was admitted to an acute care hospital in Nevada on August 18. The septuagenarian developed septic shock and died in early September. “The isolate (victim's wound specimen) was resistant to 26 antibiotics, including all aminoglycosides and polymyxins tested, and intermediately resistant to tigecycline (a tetracycline derivative developed in response to emerging antibiotic resistance)," the CDC said in its Morbidity and Mortality Weekly Report released on Friday.NDM, controversially named after New Delhi as it was first detected in a Swedish patient of Indian origin in 2008, is not an uncommon occurrence in ICUs worldwide but doctors say what has shocked them in this case is its resistance to colistin -an old drug known for its toxicity. Critical care experts often use to colistin to “trick" the bacteria when the most sophisticated of antibiotics, called carbapenems, fail.“Misuse of high-end antibiotics for common health conditions is rampant in hospitals and among people. When this happens, the bacteria starts to build a barrier along its cell wall or enzymes to fight them. Some groups, for example the Klebsiella pneumoniae, may get the right barrier or enzyme. These are called superbugs," said Sumit Ray, vice chairperson of critical care at Ganga Ram Hospital. He added that superbugs were not uncommon but pan-resistance was an emerging phenomenon with "catastrophic consequences".AIIMS microbiologist Dr Purva Mathur said at least eight patients had been identified with colistin-resistant Klebsiella pneumoniae at the trauma centre recently. Antibiotic resistance, she said, was seen in nearly 40% of ICU patients in India. "There are four common ways in which superbugs attack - ventilator-associated pneumonia, surgical site infection, central line associated blood stream infection and catheter-associated urinary tract infection. If hospitals ensure proper care to avoid such infections, many lives can be saved," she said.Dr Suranjit Chatterjee, senior consultant for internal medicine at Apollo Hospital, said terminally ill patients, cancer patients and those undergoing organ transplant remained the most vulnerable to superbug attacks in hospitals.“In the past decade, no new an tibiotic has been developed globally . It is highly unlikely to be developed soon. Prevention is the only way to fight this threat,“ he said.Medical experts say pharmaceutical majors focus less on research for newer broad spectrum antibiotics as their shelf life is less compared to drugs meant for chronic illnesses. “A new antibiotic may be used for limited period but diabetes drugs will be used for years by patients. Also, the antibiotic may become useless soon if the bacteria develops resistance to it. This is a major cause of slowness in drug discovery to fight antimicrobial resistance,“ said an expert.The World Health Organisation has already called for action across government sectors and societies to fight antibiotic resistance. “Without effective antibiotics, the success of major surgery and cancer chemotherapy would be compromised. The cost of healthcare for patients with resistant infections is higher than care for patients with non-resistant infections due to longer duration of illness, additional tests and use of more expensive drugs,“ it says. Globally , 4.8 lakh people develop multidrug resistant TB each year, says WHO, and drug resistance is starting to complicate the fight against HIV and malaria as well.