NDM-1 (New Delhi metallo-beta-lactamase)

  • Medical Author:
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What is the prognosis for a person infected with NDM-1 producing bacteria?

NDM-1 infections can be successfully treated if they are identified early and if colistin or other appropriate agents are used promptly. As stated above, antibiotic sensitivity testing is standard in clinical laboratories and can be used to identify carbapenem-resistant strains and to guide antibiotic therapy. However, antibiotic sensitivity testing usually takes two days because the bacteria must be cultured in the laboratory.

Can infections with bacteria containing NDM-1 be prevented?

The risk of person-to-person spread of NDM-1 infection can be reduced by practicing good hand hygiene. This includes washing or disinfecting hands after using the bathroom and before preparing food. In hospitals, patients with suspected NDM-1 infections should be placed in a private room and cover gowns and gloves should be used by health-care personnel. Other barrier methods should be used if contamination is likely (for example, eye protection if splashing is possible). Strict hand hygiene should be observed. Hospitals should ensure that their laboratories are equipped to test for carbapenem resistance and hospital infection-control programs should review resistance patterns regularly.

To reduce the risk that NDM-1 will develop in bacteria, it is important to use existing antibiotics wisely. Carbapenem antibiotics should only be used when bacteria are resistant to older agents. Antibiotics should always be dosed appropriately.

Where can people find more information about NDM-1 producing bacteria?

More information about NDM-1 is available from the following sites:

Centers for Disease Control and Prevention
"Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-Lactamase --- United States, 2010." http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5924a5.htm

Centers for Disease Control and Prevention
"Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities." <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5810a4.htm>.

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCES:

Kumarasamy, K.K., M.A. Toleman, T.R. Walsh, J. Bagaria, F. Butt, et al. "Emergence of a New Antibiotic Resistance Mechanism in India, Pakistan, and the UK: A Molecular, Biological, and Epidemiological Study." Lancet Infect Dis 10 (2010): 597-602.

United States. Centers for Disease Control and Prevention. "Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-Lactamase --- United States, 2010." MMWR 59.24 (2010): 750. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5924a5.htm>.

United States. Centers for Disease Control and Prevention. "Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities." MMWR 58.10 Mar. 20, 2009: 256-260. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5810a4.htm>.

Medically Reviewed by a Doctor on 6/30/2015

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