New Delhi metallo-beta-lactamase 1

Klebsiella pneumoniae 01

Carbapenem

NDM-1 active site 4HL2

colistin

New Delhi metallo-beta-lactamase 1 (NDM-1) is an enzyme that makes bacteria resistant to a broad range of beta-lactam antibiotics. These antibiotics include the carbapenems, which are a mainstay for the treatment of antibiotic-resistant bacterial infections. The gene for NDM-1 can be transferred between different bacteria, leading to a rapid spread of resistance. This has raised significant concerns within the medical community about the potential for widespread antibiotic resistance, making some infections difficult or even impossible to treat.

Discovery

NDM-1 was first identified in 2009 in a Klebsiella pneumoniae isolate from a Swedish patient of Indian origin who had been hospitalized in New Delhi, India. Since then, bacteria carrying the NDM-1 gene have been identified in various parts of the world, indicating a rapid spread facilitated by international travel and medical tourism.

Mechanism

The NDM-1 enzyme breaks down beta-lactam antibiotics, rendering them ineffective. This resistance mechanism affects a wide range of antibiotics, including the penicillins, cephalosporins, and carbapenems. The gene encoding NDM-1 is often located on plasmids, which are small pieces of DNA that can be transferred between bacteria. This facilitates the spread of resistance among different species of bacteria.

Clinical Significance

The emergence of NDM-1-producing bacteria is a significant public health concern because it limits the treatment options for infections caused by these organisms. Infections with bacteria that produce NDM-1 have been associated with high rates of morbidity and mortality, particularly in healthcare settings where vulnerable patients may be exposed to these resistant organisms.

Prevention and Control

Efforts to control the spread of NDM-1-producing bacteria include improved infection control practices in healthcare settings, such as hand hygiene and the isolation of infected patients. Surveillance and reporting of cases are also crucial for monitoring the spread of these bacteria and informing public health strategies. Research into new antibiotics and treatments that can overcome NDM-1-mediated resistance is ongoing.

See Also

• Antibiotic resistance
• Carbapenem-resistant Enterobacteriaceae
• Beta-lactam antibiotic
• Plasmid