Indian National Science Academy, Proceedings- Indian National Science Academy, 3(80), p. 547, 2014
DOI: 10.16943/ptinsa/2014/v80i3/55132
Full text: Unavailable
New β-lactamases with ever-broadening substrate specificity are disseminating rapidly all over the world. In the recent years, extent of resistance of human pathogens to β-lactam antibiotics is increasing due to the emergence of "new" carbapenemase-producers. New Delhi metallo-β-lactamase (NDM) is the latest carbapenemasc, 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 blaNDMl 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.