NDM-1: A new health threat

New Delhi metallo-ß-lactamase 1 (NDM-1) makes bacteria known as Enterobacter - highly resistant to almost all antibiotics, including the most powerful class called carbapenems - a class of the drugs often reserved for emergency use and to treat infections caused by other multi-resistant bugs.

NDM-1 that makes bacteria resistant to almost all antibiotics has appeared in India, Pakistan and Bangladesh. Overall, 44 NDM-1-positive bacteria in Chennai, 26 in Haryana, and 73 in other sites in Bangladesh and Pakistan were found.

It has also been identified in patients of the United Kingdom (UK) who underwent surgery. Almost 37 NDM-1 positive bacteria were found in UK.

Researchers collected samples of from patients in the community from two places in India, Chennai and Haryana, and from patients referred to Britain's national reference laboratory between 2007 and 2009.

Signs of the bacteria were found in India, Bangladesh, Pakistan and the United Kingdom. It was most commonly found in a pneumonia strain and an E. coli strain.

New Delhi metallo-ß-lactamase 1 or NDM-1 is an enzyme found in a group of bacteria (Enterobacteriaceae) that are commonly found in the gut, and commonly cause urinary tract infectons.

There are limited treatment options to manage infections by the resistant bacteria carrying NDM-1.

There was no genetic similarity between the UK and Indian strains, as admitted by the authors of the article.

Reference: The Lancet Infectious Diseases

If this emerging public health threat is ignored, sooner or later the medical community could be confronted with carbapenem-resistant (bacteria) that cause common infections, resulting in treatment failures with substantial increases in health-care costs.

The potential of NDM-1 to be a worldwide public health problem is great, and coordinated international surveillance is needed.

Reference: The Lancet Infectious Diseases