NDM-1 risk underlines need for good infection control

The Lancet Infectious Disease journal today reports that New Delhi Metallo-beta-lactamase -1 (NDM-1) which is present in 1 per cent to 3 per cent of patients in India, has been observed in 50 patients in the UK over the last three years. 

NDM-1 has been found in bacteria that can cause fatal pneumonia and urinary tract infections.

Two of the UK patients died although both also had an underlying serious illness. The other patients required long term treatment in isolation.

Some of the infected British patients had travelled to India for kidney or bone marrow transplants, dialysis, pregnancy care or burns treatment, while others had undergone cosmetic surgery such as “tummy tucks”. Previous cases have emerged in holidaymakers who picked up the bacteria while hospitalised in Greece and Turkey after a moped accident.

The Health Protection Agency says the enzyme is a “notable public health risk” and is urging vigilance.

Lancet study co-author, Dr David Livermore, director of antibiotic resistance monitoring at the HPA, said: “The findings of this paper show that resistance to one of the major groups of antibiotics, the carbapenems, is widespread in India. This is important because carbapenems were often the last ‘good’ antibiotics active against bacteria that already were resistant to more standard drugs.

“We have now also identified bacteria with this type of resistance - NDM - in around 50 patients in the UK.  Most, not all, had previously travelled to the Indian subcontinent, and many had received hospital treatment there.  International travel gives a great potential for spread of resistant bacteria between countries.

“Few antibiotics remain active against these bacteria.  Their spread underscores the need for good infection control in hospitals both in the UK and overseas, and the need for new antibiotic development.” 

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