Worldwide Dissemination of the NDM-Type Carbapenemases in Gram-Negative Bacteria

Author:

Dortet Laurent1,Poirel Laurent12,Nordmann Patrice12

Affiliation:

1. INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France

2. Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, 3 Rue Albert Gockel, 1700 Fribourg, Switzerland

Abstract

The emergence of one of the most recently described carbapenemases, namely, the New Delhi metallo-lactamase (NDM-1), constitutes a critical and growingly important medical issue. This resistance trait compromises the efficacy of almost all lactams (except aztreonam), including the last resort carbapenems. Therapeutical options may remain limited mostly to colistin, tigecycline, and fosfomycin. The main known reservoir of NDM producers is the Indian subcontinent whereas a secondary reservoir seems to have established the Balkans regions and the Middle East. Although the spread ofblaNDM-like genes (several variants) is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified inP. aeruginosaandAcinetobacterspp.Acinetobactersp. may play a pivotal role for spreadingblaNDMgenes for its natural reservoir to Enterobacteriaceae. Rapid diagnostic techniques (Carba NP test) and screening of carriers are the cornerstone to try to contain this outbreak which threatens the efficacy of the modern medicine.

Publisher

Hindawi Limited

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine

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