New delhi metallo beta- lactamase-1; incidence and threats.

Abstract

Carbapenems are among the few useful antibiotics against multidrug resistant Gram negative bacteria particularly those with extended spectrum beta-lactamase. Resistance to carbapenems is mediated by loss of outer membrane proteins and production of beta lactamase that is capable of hydrolyzing carbapenems. Many of the patients were hospitalized in Asia pacific region, had new type of metallo beta lactamase designated as New Delhi Metallo-1 (NDM-1). Further, the broad resistance carried on these plasmids a matter of concern for India. Although, beta-lactams have been widely used as the mainstay of treatment for several bacterial infections, carbapenems often becomes last resort. Carbapenem resistance due to acquired carbapenemases has emerged, spread since 2000, particularly due to these bacteria are source of hospital-acquired infections. Carbapenemases differ from one another, including enzymes from class B (metallo-beta-lactamases, MBLs), class A and class D (serine carbapenemases). The most prevalent carbapenemase was in Enterobacteriaceae, KPC-type class-A carbapenemase, from Klebsiella pneumonia, especially in the United States, Asia, the United Kingdom, Israel and southern Europe. Globalization and population migration is one of the major factors in disseminating antimicrobial drug-resistant bacteria. The New Delhi metallo-beta-lactamase (NDM-1) is a novel type of MBL named after the city of origin. Since an alarming report was from Asia Pacific region, and worldwide dissemination of a new ‘superbug’ is of concern. However, since August 2010, spreading and dissemination has occurred, from all the continents, including the United States and Canada, European countries, Japan, Africa, Oman and Australia. Although, one reported death due to the bacterium carrying NDM-1, reported in a Belgian man, concern is the casualty and the trip to these regions is a matter of question. In the present review paper we report the types of NDM-1, genes involved for the resistance, mechanism of resistance, epidemiology, Laboratory diagnosis, treatments and possible control measures of NDM-1.