New Delhi metallo-β-lactamase-1: local acquisition in Ontario, Canada, and challenges in detection

CMAJ. 2011 Aug 9;183(11):1257-61. doi: 10.1503/cmaj.110477. Epub 2011 May 30.

Abstract

New Delhi metallo-β-lactamase-1 (NDM-1) is a recently identified metallo-β-lactamase that confers resistance to carbapenems and all other β-lactam antibiotics, with the exception of aztreonam. NDM-1 is also associated with resistance to many other classes of antibiotics. The enzyme was first identified in organisms isolated from a patient in Sweden who had previously received medical treatment in India, but it is now recognized as endemic throughout India and Pakistan and has spread worldwide. The gene encoding NDM-1 has been found predominantly in Escherichia coli and Klebsiella pneumoniae. We describe the isolation NDM-1-producing organisms from two patients in Toronto, Ontario. To the best of our knowledge, this is the first report of an organism producing NDM-1 that was locally acquired in Canada. We also discuss the evidence that NDM-1 can affect bacterial species other than E. coli and K. pneumoniae, the limited options for treatment and the difficulty laboratories face in detecting organisms that produce NDM-1.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Morganella morganii / enzymology
  • Morganella morganii / isolation & purification*
  • Ontario
  • Polymerase Chain Reaction
  • Proteus mirabilis / enzymology
  • Proteus mirabilis / isolation & purification*
  • Urine / microbiology
  • beta-Lactam Resistance
  • beta-Lactamases / genetics
  • beta-Lactamases / urine*

Substances

  • beta-Lactamases
  • beta-lactamase NDM-1