New Delhi metallo-beta-lactamase 1–producing Enterobacteriaceae: emergence and response in Europe

Abstract

Acquired carbapenemases confer extensive antibiotic resistance to Enterobacteriaceae and represent a public health threat. A novel acquired carbapenemase, New Delhi metallo-beta-lactamase 1 (NDM-1), has recently been described in the United Kingdom and Sweden, mostly in patients who had received care on the Indian subcontinent. We conducted a survey among 29 European countries (the European Union Member States, Iceland and Norway) to gather information on the spread of NDM-1-producing Enterobacteriaceae in Europe, on public health responses and on available national guidance on detection, surveillance and control. A total of 77 cases were reported from 13 countries from 2008 to 2010. Klebsiella pneumoniae was the most frequently reported species with 54%. Among 55 cases with recorded travel history, 31 had previously travelled or been admitted to a hospital in India or Pakistan and five had been hospitalised in the Balkan region. Possible nosocomial acquisition accounted for 13 of 77 cases. National guidance on NDM-1 detection was available in 14 countries and on NDM-1 control in 11 countries. In conclusion, NDM-1 is spreading across Europe, where it is frequently linked to a history of healthcare abroad, but also to emerging nosocomial transmission. National guidance in response to the threat of carbapenemase-producing Enterobacteriaceae is available in approximately half of the surveyed European countries. Surveillance of carbapenemase- producing Enterobacteriaceae must be enhanced in Europe and effective control measures identified and implemented.

Long-term control of carbapenemase-producing Enterobacteriaceae at the scale of a large French multihospital institution: a nine-year experience, France, 2004 to 2012

“…Identification of patients transferred from or previously hospitalised abroad in the prior year was most likely crucial, as this allowed to rapidly screen these patients at risk to be colonised by a CPE strain and to implement pre-emptive barrier precautions to avoid transmission to other patients [21]. This recommendation has been subsequently extended at the national level by French Health authorities in August 2010 [22], a measure that could have contributed to improve adherence to organising early screening of such patients in our institution.…”

Molecular Detection of New Delhi Metallo-Beta-Lactamase-1 (NDM-1) Positive Bacteria from Environmental and Drinking Water Samples by Loop Mediated Isothermal Amplification of bla NDM-1

“…NDM-1 was reported in 11 different bacterial species including Escherichia coli, Klebsiella sp., Shigella boydii and Vibrio cholera [2] indicating the potential of horizontal gene transfer. NDM-1 producing bacteria were reported from several countries around the world [3][4][5][6][7]. World Health Organization (WHO) has urged all the countries to implement infection control measures to contain the spread of these bacteria.…”

Efficient surveillance for healthcare-associated infections spreading between hospitals

“…Local and national surveillance is considered an important component of the strategy to control these strains (6)(7)(8). However, surveillance is costly in monetary terms, effort, and facilities and it is important to consider ways in which surveillance systems can be made more efficient both at the hospital and the national level.…”