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

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  • Laurent Dortet
    INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
  • Laurent Poirel
    INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
  • Patrice Nordmann
    INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France

書誌事項

公開日
2014
権利情報
  • http://creativecommons.org/licenses/by/3.0/
DOI
  • 10.1155/2014/249856
公開者
Hindawi Limited

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説明

<jats:p>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 of<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>b</mml:mi><mml:mi>l</mml:mi><mml:msub><mml:mrow><mml:mi>a</mml:mi></mml:mrow><mml:mrow><mml:mtext>NDM</mml:mtext></mml:mrow></mml:msub></mml:math>-like genes (several variants) is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified in<jats:italic>P. aeruginosa</jats:italic>and<jats:italic>Acinetobacter</jats:italic>spp.<jats:italic>Acinetobacter</jats:italic>sp. may play a pivotal role for spreading<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>b</mml:mi><mml:mi>l</mml:mi><mml:msub><mml:mrow><mml:mi>a</mml:mi></mml:mrow><mml:mrow><mml:mtext>NDM</mml:mtext></mml:mrow></mml:msub></mml:math>genes 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.</jats:p>

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