title: New Delhi metallo-β-lactamase-1: local acquisition in Ontario, Canada, and challenges in detection.
abstract: New Delhi metallo-β-lactamase-1 (NDM-1) is a recently identified metallo-β-lactamase that confers resistance to carbapenems and all other β-lactam antibiotics, with the exception of aztreonam. NDM-1 is also associated with resistance to many other classes of antibiotics. The enzyme was first identified in organisms isolated from a patient in Sweden who had previously received medical treatment in India, but it is now recognized as endemic throughout India and Pakistan and has spread worldwide. The gene encoding NDM-1 has been found predominantly in Escherichia coli and Klebsiella pneumoniae. We describe the isolation NDM-1-producing organisms from two patients in Toronto, Ontario. To the best of our knowledge, this is the first report of an organism producing NDM-1 that was locally acquired in Canada. We also discuss the evidence that NDM-1 can affect bacterial species other than E. coli and K. pneumoniae, the limited options for treatment and the difficulty laboratories face in detecting organisms that produce NDM-1.
authors.affiliation: University Health Network and Mount Sinai Hospital Joseph and Wolf Lebovic Health Complex Department of Microbiology, Toronto, Canada.
authors.forename: Julianne V
authors.initials: JV
authors.lastname: Kus
authors.forename: Manal
authors.initials: M
authors.lastname: Tadros
authors.forename: Andrew
authors.initials: A
authors.lastname: Simor
authors.forename: Donald E
authors.initials: DE
authors.lastname: Low
authors.forename: Allison J
authors.initials: AJ
authors.lastname: McGeer
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Willey
authors.forename: Cindy
authors.initials: C
authors.lastname: Larocque
authors.forename: Karen
authors.initials: K
authors.lastname: Pike
authors.forename: Iris-Ann
authors.initials: IA
authors.lastname: Edwards
authors.forename: Helen
authors.initials: H
authors.lastname: Dedier
authors.forename: Roberto
authors.initials: R
authors.lastname: Melano
authors.forename: David A
authors.initials: DA
authors.lastname: Boyd
authors.forename: Michael R
authors.initials: MR
authors.lastname: Mulvey
authors.forename: Lisa
authors.initials: L
authors.lastname: Louie
authors.forename: Christopher
authors.initials: C
authors.lastname: Okeahialam
authors.forename: Mark
authors.initials: M
authors.lastname: Bayley
authors.forename: Cynthia
authors.initials: C
authors.lastname: Whitehead
authors.forename: Denyse
authors.initials: D
authors.lastname: Richardson
authors.forename: Lesley
authors.initials: L
authors.lastname: Carr
authors.forename: Fatema
authors.initials: F
authors.lastname: Jinnah
authors.forename: Susan M
authors.initials: SM
authors.lastname: Poutanen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D020613:Morganella morganii / Q000201:enzymology / Q000302:isolation & purification*; D009864:Ontario; D016133:Polymerase Chain Reaction; D011513:Proteus mirabilis / Q000201:enzymology / Q000302:isolation & purification*; D014556:Urine / Q000382:microbiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000652:urine*
chemical_list: D001618:beta-Lactamases; C552864:beta-lactamase NDM-1