Does broad-spectrum beta-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria?

Patrice Nordmann; Laurent Poirel; Mark A Toleman; Timothy R Walsh

doi:10.1093/jac/dkq520

Does broad-spectrum beta-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria?

J Antimicrob Chemother. 2011 Apr;66(4):689-92. doi: 10.1093/jac/dkq520. Epub 2011 Jan 28.

Authors

Patrice Nordmann¹, Laurent Poirel, Mark A Toleman, Timothy R Walsh

Affiliation

¹ Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotics, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, K.-Bicêtre, France. nordmann.patrice@bct.aphp.fr

PMID: 21393184
DOI: 10.1093/jac/dkq520

Abstract

The NDM-1 gene, first identified in Sweden in 2008 in Klebsiella pneumoniae from a patient hospitalized in New Delhi, encodes a metallo-β-lactamase that inactivates all β-lactams except aztreonam. This bla(NDM-1) gene has been identified in hospital-acquired bacterial species, such as K. pneumoniae, but also in the typical community-acquired species, Escherichia coli. This gene has been identified in strains that possess other resistance mechanisms contributing to their multidrug resistance patterns. It has been recently extensively reported from the UK, India and Pakistan and, albeit to a lesser extent, from a number of other countries worldwide. In most of the cases a link with the Indian subcontinent has also been established. To stem the onslaught of NDM producers, early identification of cases of NDM-related infections and prevention of their spread by implementing screening, hygiene measures and the isolation of carriers is needed.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Communicable Diseases, Emerging / drug therapy
Communicable Diseases, Emerging / epidemiology
Communicable Diseases, Emerging / microbiology
Disease Transmission, Infectious / prevention & control
Escherichia coli / drug effects
Escherichia coli / enzymology*
Escherichia coli / isolation & purification
Escherichia coli Infections / drug therapy
Escherichia coli Infections / epidemiology*
Escherichia coli Infections / microbiology
Humans
India / epidemiology
Infection Control / methods
Klebsiella Infections / drug therapy
Klebsiella Infections / epidemiology*
Klebsiella Infections / microbiology
Klebsiella pneumoniae / drug effects
Klebsiella pneumoniae / enzymology*
Klebsiella pneumoniae / isolation & purification
Mass Screening / methods
Pakistan / epidemiology
Pandemics
Sweden / epidemiology
United Kingdom / epidemiology
beta-Lactam Resistance*
beta-Lactamases / biosynthesis*
beta-Lactams / pharmacology*
beta-Lactams / therapeutic use

Substances

beta-Lactams
beta-Lactamases
beta-lactamase NDM-1