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NDM-1 (cont.)

IN THIS ARTICLE

What Is the Prognosis for a Person Infected With NDM-1 Producing Bacteria?

The prognosis (outcome) for a person infected with NDM-1 is related to the patient's overall condition at the time of diagnosis and appropriate treatment. In general, patients with antibiotic-resistant bacteria have more complications and longer hospital stays than those who have antibiotic-susceptible organisms. The quicker the bacteria are shown to contain NDM-1, the faster appropriate treatment can begin and the better the prognosis for the patient. If the NDM-1-producing bacteria are susceptible to colistin, the prognosis is usually good. However, patients on respirators, immunocompromised patients, and patients in intensive-care units have a more guarded prognosis.

Can Infections With Bacteria Containing NDM-1 Be Prevented?

Patient Comments

The chance of infections with bacteria containing NDM-1 can be reduced or even prevented by fairly simple hygienic methods that include hand washing, adequate treatment of water supplies, washing vegetables, and avoiding areas and people known to harbor NDM-1-producing bacteria. The usual infection protective techniques available in hospitals should be used. Patients with NDM-1 bacteria should be treated like patients with MRSA, with a private room with gloves, and masks and gowns should be made available for caregivers and visitors.

There is no vaccine available for bacteria that produce NDM-1, and it is unlikely one will be developed because so many bacterial strains may have the potential to produce NDM-1 if given the appropriate genes.

Why Are Doctors and Researchers So Concerned About Bacteria With NDM-1?

Many medical caregivers and researchers are concerned about NDM-1 because it renders some of the most useful and powerful antibiotics (carbapenems) ineffective. These antibiotics are often the medications of choice for severe infections. In addition, since the blaNDM-1 gene that produces the enzyme is often associated with other genes that code for other antibiotic-resistance factors, they are concerned that such resistance will be quickly passed to most gram-negative bacteria, thus rendering a huge group of bacteria resistant to most of the currently used antibiotics. Although this spread is unlikely to be considered a pandemic like bird or swine flu, outbreaks of diseases caused by NDM-1 bacteria could result in high mortality. Researchers also are concerned that current antibiotic susceptibility tests often may take a minimum of two days to complete, which for a critically infected patient may be a long time to be treated with antibiotics that may not have the ability to inhibit or kill infecting bacteria.

The field of research on NDM-1 is extremely active at this time. There should be many developments in clinical diagnostic methods, antibiotic treatment plans, and antibiotics in the near future. Unfortunately, the number of people infected with and carrying NDM-1 bacteria is likely to increase rapidly. Researchers plan to try to stay a step ahead of these potentially dangerous antibiotic-resistant bacteria, but there is no guarantee they will be successful. Prevention of infection is the best defense against these bacteria.

Where Can People Find More Information About NDM-1 Producing Bacteria?

"Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-Lactamase" - United States, 2010." Centers for Disease Control and Prevention

"Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities." Centers for Disease Control and Prevention

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCES:

Deshpande, P., C. Rodrigues, A. Shetty, et al. "New Delhi Metallo-β lactamase (NDM-1) in Enterobacteriaceae: Treatment Options With Carbapenems Compromised." J. Assn. Physicians India 58 (2010): 147–150.

Yong, D., M. Toleman, C. Giske, et al. "Characterization of a New Metallo-β-Lactamase Gene, blaNDM-1, and a Novel Erythromycin Esterase Gene Carried on a Unique Genetic Structure in Klebsiella pneumoniae Sequence Type 14 from India." Antimicrob Agents and Chemother. 53.12 Dec. 2009: 5046-5054.


Medically Reviewed by a Doctor on 7/7/2016

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