Two antibiotic-resistant superbugs have recently emerged in Japan.

In Tokyo, dozens of patients, mostly elderly, have been infected with Acinetobacter, and at least 12 deaths have been reported. On the other hand, thankfully, no deaths have yet been reported from infection with E. coli with the NDM-1 gene.

Following are questions and answers on the recent superbug cases:

What is the difference between the two superbugs?

Acinetobacter is a bacteria resistant to most antibiotics. Dozens of infections have been found at Teikyo University Hospital, Yurin Hospital, Tokyo Metropolitan Geriatric Hospital and other hospitals.

NDM-1 makes a bacterium resistant to most antibiotics. So far it has turned up in only one man in Japan, a patient in his 50s at Dokkyo Medical University Hospital in Tochigi Prefecture, according to the Health, Labor and Welfare Ministry. Outside Japan, NDM-1 has occurred in pneumobacillus, a germ that causes pneumonia, and other germs, ministry official Shuichiro Hayashi said.

Acinetobacter is commonly found in soil and water and easily survives on various surfaces, so hand-washing is recommended to prevent infections.

The NDM-1 gene was only recently discovered. The first infection was confirmed in April 2008 in an Indian person living in Sweden, according to Infectious Disease Surveillance Center spokesman Masaaki Nishikawa.

After the British medical journal The Lancet published an article about the increasing number of NDM-1 cases last month, the health ministry called on hospitals to investigate, leading to the discovery at Dokkyo Medical University Hospital, a ministry official said.

People from Britain, the Netherlands, Belgium, Australia and America were reportedly infected with germs containing the NDM-1 gene. The origin is thought to be India and Pakistan, where many of the patients had reportedly undergone cosmetic surgery. The infected Japanese man had reportedly been to India.

What are the symptoms?

It depends on what part of the body the bacteria enter. If Acinetobacter enters the lungs, patients may contract pneumonia, Hayashi said, adding that it generally sickens people with pre-existing diseases while healthy people will not have notable symptoms. Symptoms of E. coli with NDM-1 are the same as with regular E. coli, such as vomiting, diarrhea and fever that are typical in food-poisoning cases.

How are people infected?

Contact infection and droplet infection. Thus, a tiny drop of saliva released while talking can transmit Acinetobacter and E. coli. In the recent cases, the Acinetobacter infections are thought to have occurred in hospitals. Police are reportedly investigating hospitals on possible charges of negligence for failing to maintain a sufficiently clean environment.

Avoiding travel to India and Pakistan appears to be the most realistic option for avoiding infection with germs containing NDM-1.

What’s the cure for Acinetobacter infection?

For healthy people carrying the bacteria and showing no symptoms, no treatment is necessary. Otherwise, antibiotics will be administered, though it’s unclear which kind and in what amount, the Infectious Disease Surveillance Center says on its website. The treatment for infection with germs containing NDM-1 is also uncertain. The infected man has since recovered.

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