Global spread of antibiotic resistance: the example of New Delhi metallo-β-lactamase (NDM)-mediated carbapenem resistance

Abstract

The rapidity with which new types of antibiotic resistance can disseminate globally following their initial emergence or recognition is exemplified by the novel carbapenemase New Delhi metallo-blactamase (NDM). The first documented case of infection caused by bacteria producing NDM occurred in 2008, although retrospective analyses of stored cultures have identified the gene encoding this enzyme (bla NDM ) in Enterobacteriaceae isolated in 2006. Since its first description, NDM carbapenemase has been reported from 40 countries worldwide, encompassing all continents except South America and Antarctica. The spread of NDM has a complex epidemiology involving the spread of a variety of species of NDM-positive bacteria and the interstrain, inter-species and inter-genus transmission of diverse plasmids containing bla NDM , with the latter mechanism having played a more prominent role to date. The spread of NDM illustrates that antibiotic resistance is a public health problem that transcends national borders and will require international cooperation between health authorities if it is to be controlled.

Genome sequencing defines phylogeny and spread of methicillin-resistant Staphylococcus aureus in a high transmission setting

“…The problem has been recognized as a global one, since the localized emergence of a clinically significant resistance determinant is almost inevitably followed by a pattern of widespread dissemination (Johnson and Woodford 2013). Antimicrobial resistance in resourcepoor settings is fueled by weak control of antibiotic prescribing and stewardship both in the community and hospitals, and by weak infection control infrastructure that fails to prevent the transmission of nosocomial pathogens-many of which are multidrug resistant.…”

The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

“…However, antimicrobial resistance among Gram-negative bacteria, particularly among the Enterobacteriaceae and the non-fermenters, has become one of the most serious public health concerns worldwide (Giske et al, 2008;Livermore, 2012). The global dissemination of resistance has recently received much attention, especially following reports of the international spread of multi-resistant Enterobacteriaceae, particularly strains resistant to cephalosporins due to the production of CTX-M-type extended-spectrum b-lactamases (ESBLs) and strains producing carbapenemases such as KPC and NDM (Nordmann et al, 2011;Johnson & Woodford, 2013). The spread of resistance determinants is facilitated by a number of factors, including presence on genetic mobile elements, antibiotic misuse, poor infection control practices, and increased international travel.…”

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