NDM-1 facts
NDM-1 stands for New Delhi metallo-beta-lactamase, which is an enzyme that destroys beta-lactam antibiotics including the penicillins, cephalosporins, and carbapenems.
NDM-1 has been reported most commonly from India and Pakistan but is spreading throughout the world as people travel from country to country.
The first three cases of NDM-1 in the United States were reported in June 2010.
Bacteria that express NDM-1 usually have other resistance factors. Most strains are resistant to all commonly used antibiotics.
Routine antibiotic-sensitivity testing can detect resistance to beta-lactam antibiotics. Specific testing for NDM-1 is not routinely available. Fortunately, it is not necessary to determine if carbapenem resistance is specifically due to NDM-1 because treatment is guided by the antibiotic-sensitivity testing.
Most NDM-1 strains remain sensitive to an older, little-used antibiotic called colistin. Some strains have also been sensitive to tigecycline or aztreonam.
NDM-1 is carried by bacteria that commonly inhabit the bowel. Strains spread from person to person through contact with contaminated hands or items.
Good hand hygiene practices will reduce the risk of spreading or acquiring NDM-1. In hospitals, hand hygiene is critical and patients with NDM-1 should be placed in private rooms and health-care workers should used gowns and gloves when entering the room.
To reduce the risk that NDM-1 will arise, physicians and hospitals should ensure that antibiotics are used judiciously and appropriately.