By joshua 
Dangerous Superbug Gene Found in Nigerian Hospital, Study Confirms
….Low prevalence offers hope, but single detection raises alarm about antibiotic resistance spread
Health Science | January 22, 2026
A gene that makes bacteria resistant to our most powerful antibiotics has been detected in a Nigerian hospital, according to new research that highlights both encouraging and worrying trends in the fight against antimicrobial resistance.
Scientists examining bacteria from urinary tract infection patients in Onitsha found the NDM-1 gene in one of 30 samples tested, a prevalence rate of 3.33%. Whilst the low figure suggests the gene has not yet become widespread in the region, its mere presence signals potential danger given how easily such resistance can spread between bacteria.
The study, published in Global Multidisciplinary Journal, represents one of the first systematic attempts to track this particular resistance mechanism in southeastern Nigeria, providing crucial baseline data for monitoring future trends.
THE LAST LINE OF DEFENCE
The NDM-1 gene codes for an enzyme called New Delhi Metallo-beta-lactamase-1, which breaks down carbapenem antibiotics. Carbapenems represent what doctors often call “last-resort” treatments, reserved for severe infections when other antibiotics have failed.
When bacteria acquire NDM-1, they become resistant to nearly all beta-lactam antibiotics, a class that includes commonly used drugs like penicillin, amoxicillin, and cephalosporins, as well as the more powerful carbapenems. This leaves clinicians with extremely limited treatment options, sometimes forcing them to use older, more toxic antibiotics with worse side effects.
The gene was first identified in 2008 in a Swedish patient who had received medical care in New Delhi, hence its name. Since then, it has spread globally, detected in bacteria from every inhabited continent. Its presence in hospital settings is particularly concerning because it often occurs in bacteria already resistant to multiple other drugs.
“Finding NDM-1 in even a single isolate is significant,” explains Dr Chinaza Maria Ozuluoha from Nnamdi Azikiwe University, the study’s lead author. “These genes don’t stay confined to individual bacteria. They exist on mobile genetic elements called plasmids that can transfer between different bacterial species, potentially spreading resistance widely.”
THE ONITSHA STUDY
The research team collected 30 bacterial isolates from patients diagnosed with urinary tract infections at healthcare facilities in Onitsha Metropolis. These samples represented bacteria already causing clinical infections, making their resistance patterns directly relevant to treatment decisions.
Laboratory analysis involved extracting DNA from each bacterial sample and using polymerase chain reaction (PCR), a technique that amplifies specific genetic sequences, to test for the presence of NDM-1. The amplified DNA was then separated using gel electrophoresis and visualised to confirm which samples carried the gene.
Of the 30 isolates tested, comprising both Klebsiella pneumoniae and Escherichia coli, the two bacterial species most commonly responsible for urinary tract infections, only one tested positive for NDM-1.
This 3.33% prevalence rate is substantially lower than figures reported from some other regions. Studies in parts of India, the Middle East, and North Africa have documented NDM-1 prevalence rates exceeding 20% in some hospital settings. Research from other African countries has shown variable rates, with some locations reporting minimal detection and others finding concerning prevalence.
WHY LOW PREVALENCE STILL MATTERS
The relatively low prevalence might seem reassuring, but public health experts caution against complacency. Antimicrobial resistance can increase rapidly once resistance genes establish themselves in bacterial populations, particularly in healthcare settings where antibiotic use is intensive.
Several factors make even low-level detection significant. First, the gene exists on plasmids, circular DNA molecules that bacteria can exchange with each other through a process called horizontal gene transfer. A single bacterium carrying NDM-1 can potentially spread the gene to many others, including different species.
Second, patients with resistant infections can carry and transmit these bacteria to others, both within hospitals and in the community. International travel further facilitates geographic spread, as evidenced by NDM-1’s rapid global dissemination since its initial discovery.
Third, the selective pressure from antibiotic use favours bacteria carrying resistance genes. In environments where carbapenem antibiotics are used, even if inappropriately or unnecessarily, bacteria with NDM-1 have survival advantages over those without it.
“We’re seeing a snapshot in time,” notes Dr Kennedy Oberhiri Obohwemu from PENKUP Research Institute, a co-author. “The question isn’t just what the prevalence is now, but what trajectory we’re on. Early detection provides an opportunity for intervention before resistance becomes entrenched.”
THE NIGERIAN CONTEXT
Nigeria faces particular challenges regarding antimicrobial resistance. Like many low and middle-income countries, it contends with limited diagnostic capacity, gaps in surveillance systems, variable infection control practices, and widespread availability of antibiotics without prescription.
Recent reviews of antimicrobial resistance in Nigeria’s healthcare system have documented concerning trends across multiple bacterial species and resistance mechanisms. Carbapenem resistance, whilst still less common than resistance to older antibiotic classes, appears to be increasing.
However, comprehensive surveillance data remains limited. Many facilities lack the laboratory capacity to detect resistance genes like NDM-1, meaning the true prevalence is unknown. The current study helps fill this gap, at least for one geographic area and time period.
The researchers emphasise that their findings from Onitsha may not represent patterns elsewhere in Nigeria. Urban and rural areas, different regions, and facilities with varying resources and patient populations could show different prevalence rates. Larger, multi-centre studies would provide more comprehensive understanding.
GLOBAL THREAT, LOCAL ACTION
The World Health Organization lists carbapenem-resistant Enterobacteriaceae, the bacterial family that includes Klebsiella and E. coli, among the critical priority pathogens requiring urgent research and development of new treatments.
International surveillance data shows rising rates of carbapenem resistance globally, with mechanisms including not just NDM-1 but other carbapenemase genes like KPC, OXA-48, and VIM. The spread of multiple resistance mechanisms complicates both treatment and surveillance efforts.
In sub-Saharan Africa, surveillance capacity varies considerably between countries. Some nations have established national antimicrobial resistance monitoring systems, whilst others rely on scattered research studies to understand resistance patterns. Regional coordination remains limited, making it difficult to track cross-border spread or identify emerging threats early.
The study’s authors call for strengthened surveillance as a priority. “You can’t manage what you don’t measure,” argues Dr Jennifer Adaeze Chukwu from the World Health Organization Nigeria office, a team member. “Regular monitoring of resistance patterns, including molecular detection of genes like NDM-1, needs to become standard practice rather than occasional research activity.”
PREVENTION STRATEGIES
Beyond surveillance, the research team emphasises several interventions to prevent wider spread of NDM-1 and similar resistance mechanisms.
Antimicrobial stewardship programmes, which promote appropriate antibiotic prescribing and use, are essential. Many infections, including some urinary tract infections, can be treated with narrower-spectrum antibiotics, reserving carbapenems for cases where they’re genuinely necessary. Reducing overall carbapenem use decreases selective pressure favouring resistant bacteria.
Infection prevention and control measures in healthcare facilities can limit transmission of resistant bacteria between patients. This includes hand hygiene, environmental cleaning, appropriate use of isolation precautions for patients with resistant infections, and proper sterilisation of medical equipment.
Access to rapid diagnostic testing would allow clinicians to identify bacterial species and resistance patterns quickly, enabling targeted treatment rather than empiric use of broad-spectrum antibiotics. However, such testing requires laboratory infrastructure that many Nigerian facilities currently lack.
Public awareness about appropriate antibiotic use also matters. Self-medication with antibiotics, purchasing drugs without prescription, and not completing prescribed courses all contribute to resistance development.
RESEARCH LIMITATIONS AND FUTURE DIRECTIONS
The researchers acknowledge several limitations of their study. The sample size of 30 isolates, whilst sufficient for initial surveillance, is relatively small. Larger studies examining hundreds or thousands of isolates would provide more precise prevalence estimates and allow analysis of risk factors associated with NDM-1 carriage.
The study examined only urinary tract infection isolates. NDM-1 has been detected in bacteria causing various infection types, including bloodstream infections, pneumonia, and surgical site infections. Broader sampling across different infection types and patient populations would give a more complete picture.
The research identified presence or absence of NDM-1 but did not characterise the genetic context in detail. Understanding which plasmids carry the gene, what other resistance genes are co-located, and how the genetic elements relate to those found elsewhere could illuminate transmission patterns and origins.
Clinical outcome data was not included. Knowing whether patients with NDM-1-positive infections had worse outcomes, longer hospital stays, or higher mortality rates compared to those with susceptible infections would strengthen the case for prevention efforts.
Future research should address these gaps whilst expanding geographic coverage. Regular, systematic surveillance across multiple Nigerian states would track trends over time and identify hotspots requiring targeted intervention.
A WINDOW OF OPPORTUNITY
The study’s findings suggest that Nigeria may currently be in a position to prevent widespread establishment of NDM-1 rather than attempting to control it after it becomes endemic.
“Low prevalence creates an opportunity,” says Dr Christabel A. Ovesuor from Federal Medical Centre, Asaba, a co-author. “We can implement strong prevention and control measures now, whilst the problem is still manageable, rather than waiting until resistance is widespread and much harder to contain.”
Whether that opportunity will be seized depends on policy decisions, resource allocation, and sustained commitment to antimicrobial resistance as a health priority. The study provides the evidence base; action must follow.
ABOUT THE STUDY
The research, “Low Prevalence of Carbapenemase Gene NDM-1 in Uropathogenic Klebsiella pneumoniae and Escherichia coli: A Molecular Surveillance Study,” appears in Global Multidisciplinary Journal, Volume 5, Issue 1. The study was conducted by researchers from Nnamdi Azikiwe University, other Nigerian institutions, as well as UK universities, with support from PENKUP Research Institute in Birmingham, UK.
Check it out here:
https://www.researchgate.net/publication/399833680_Low_Prevalence_of_Carbapenemase_Gene_NDM-1_in_Uropathogenic_Klebsiella_pneumoniae_and_Escherichia_coli_A_Molecular_Surveillance_Study
https://www.grpublishing.org/journals/index.php/gmj/article/view/275/
End