Overview on the New Delhi Metallo- -Lactamase (NDM)-producers
No Thumbnail Available
Date
2025-01-09
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
New -lactamases with ever-broadening substrate specificity are disseminating rapidly all over the world. In the recent
years, extent of resistance of human pathogens to -lactam antibiotics is increasing due to the emergence of “new”
carbapenemase-producers. New Delhi metallo- -lactamase (NDM) is the latest carbapenemase, detected for the first time
during 2008, in bacteria isolated from patients epidemiologically linked to the Indian subcontinent. Apart from carbapenems,
NDM-producers are often resistant to other clinically useful antimicrobials such as aminoglycosides and fluoroquinolones.
Although the main type of NDM is NDM-1, nine variants have been identified till to date. NDM enzymes have been
detected mainly in genetically heterogeneous members of the Enterobacteriaceae family and recently in non-fermenters
and Vibrionaceae. The gene blaNDM-1 is located on plasmids of heterogeneous nature of varying sizes and is transferable
to a wide range of microbes. Although several methods for the detection of NDM-producers exist, modified Hodge test
and the detection of blaNDM-1 by PCR are generally used. Antimicrobials polymyxins (colistin) and glycylcyclines
(tigecyclines) show promising activity against NDM-producers in vitro, but there is dispute on their clinical use for safety
issues. For preventing the spread of NDM-producers, it is essential to have proper surveillance system in place and for its
containment, emphasis should be on research to develop new and safe antimicrobials active against these bugs. In this
review, an overview of all these aspects has been presented.
Description
New -lactamases with ever-broadening substrate specificity are disseminating rapidly all over the world. In the recent
years, extent of resistance of human pathogens to -lactam antibiotics is increasing due to the emergence of “new”
carbapenemase-producers. New Delhi metallo- -lactamase (NDM) is the latest carbapenemase, detected for the first time
during 2008, in bacteria isolated from patients epidemiologically linked to the Indian subcontinent. Apart from carbapenems,
NDM-producers are often resistant to other clinically useful antimicrobials such as aminoglycosides and fluoroquinolones.
Although the main type of NDM is NDM-1, nine variants have been identified till to date. NDM enzymes have been
detected mainly in genetically heterogeneous members of the Enterobacteriaceae family and recently in non-fermenters
and Vibrionaceae. The gene blaNDM-1 is located on plasmids of heterogeneous nature of varying sizes and is transferable
to a wide range of microbes. Although several methods for the detection of NDM-producers exist, modified Hodge test
and the detection of blaNDM-1 by PCR are generally used. Antimicrobials polymyxins (colistin) and glycylcyclines
(tigecyclines) show promising activity against NDM-producers in vitro, but there is dispute on their clinical use for safety
issues. For preventing the spread of NDM-producers, it is essential to have proper surveillance system in place and for its
containment, emphasis should be on research to develop new and safe antimicrobials active against these bugs. In this
review, an overview of all these aspects has been presented.