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NDM Metallo-?-Lactamases and Their Bacterial Producers in Health Care Settings.

ABSTRACT: New Delhi metallo-?-lactamase (NDM) is a metallo-?-lactamase able to hydrolyze almost all ?-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of bla NDM, with certain sequence types (STs) (for K. pneumoniae, ST11, ST14, ST15, or ST147; for E. coli, ST167, ST410, or ST617) being the most prevalent. NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, the Middle East, and the Balkans. Most bla NDM-carrying plasmids belong to limited replicon types (IncX3, IncFII, or IncC). Commonly used phenotypic tests cannot specifically identify NDM. Lateral flow immunoassays specifically detect NDM, and molecular approaches remain the reference methods for detecting bla NDM Polymyxins combined with other agents remain the mainstream options of antimicrobial treatment. Compounds able to inhibit NDM have been found, but none have been approved for clinical use. Outbreaks caused by NDM-positive strains have been reported worldwide, attributable to sources such as contaminated devices. Evidence-based guidelines on prevention and control of carbapenem-resistant Gram-negative bacteria are available, although none are specific for NDM-positive strains. NDM will remain a severe challenge in health care settings, and more studies on appropriate countermeasures are required.

SUBMITTER: Wu W

PROVIDER: S-EPMC6431124 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings.

Wu Wenjing W Feng Yu Y Tang Guangmin G Qiao Fu F McNally Alan A Zong Zhiyong Z

Clinical microbiology reviews 20190130 2

New Delhi metallo-β-lactamase (NDM) is a metallo-β-lactamase able to hydrolyze almost all β-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of blaNDM, with certain sequence types (STs) (for K. pneumoniae, ST11, ST14, ST15, or ST147; for E. coli, ST167, ST410, or ST617) being ...[more]

PMID: 30700432

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Project description:Background and objectivesMultidrug resistance and in particular, carbapenem resistant Gram-negative bacteria is spreading worldwide at an alarming rate. Among the clinically significant carbapenemases, the New Delhi Metallo-β-lactamase (NDM) is one of the most formidable. NDM efficiently hydrolyses β-lactams and is the last-resort among carbapenems. Hence, therapeutic options for NDM producer bacteria become restricted to a handful of antibiotics. The present study was undertaken to detect the prevalence of the blaNDM-variants Metallo β-lactamases (MBLs) among isolates of Pseudomonas aeruginosa recovered from various clinical samples of hospitalized patients in Baghdad, Iraq.Materials and methodsA total of 100 isolates of Gram-negative bacteria obtained from various clinical samples were subjected to antibiotic susceptibility testing by the disc-diffusion method against meropenem (10 μg), imipenem (10 μg), doripenem (10 μg), polymyxin B (10 μg), colistin (10 μg), amikacin (30 μg), gentamicin (10 μg), aztreonam (30 μg), ciprofloxacin (5 μg), levofloxacin (5 μg), ofloxacin (5 μg), cefepime (30 μg), ceftazidime (30 μg), piperacillin-tazobactam (100\10 μg), tigecycline (15 μg) and tetracycline (10 μg). The results were interpreted according to the guidelines suggested by the Clinical Laboratory Standards Institute. Presence of blaNDM was detected by PCR and it was confirmed by DNA sequencing of the gene present in the isolates that exhibited carbapenem resistance.ResultsIn the present study, four isolates of P. aeruginosa carried the blaNDM, three isolates harboured blaNDM-1 and one isolate harboured blaNDM-2. All isolates were resistant to imipenem and meropenem. The blaNDM-1 carrying isolates remained susceptible to colistin and β-lactamase inhibitors piperacillin-tazobactam.ConclusionWe are reporting emergence of the P. aeruginosa carrying the blaNDM-variant, which exhibited resistance to imipenem and meropenem for the first time in Iraq.

Dataset Information

NDM Metallo-?-Lactamases and Their Bacterial Producers in Health Care Settings.

Publications

NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings.

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