title: The emerging NDM carbapenemases.
abstract: Carbapenems were the last β-lactams retaining near-universal anti-Gram-negative activity, but carbapenemases are spreading, conferring resistance. New Delhi metallo-β-lactamase (NDM) enzymes are the latest carbapenemases to be recognized and since 2008 have been reported worldwide, mostly in bacteria from patients epidemiologically linked to the Indian subcontinent, where they occur widely in hospital and community infections, and also in contaminated urban water. The main type is NDM-1, but minor variants occur. NDM enzymes are present largely in Enterobacteriaceae, but also in non-fermenters and Vibrionaceae. Dissemination predominantly involves transfer of the blaNDM-1 gene among promiscuous plasmids and clonal outbreaks. Bacteria with NDM-1 are typically resistant to nearly all antibiotics, and reliable detection and surveillance are crucial.
authors.affiliation: Service de Bactériologie-Virologie, Hôpital de Bicêtre, Institut National de la Santé et de la Recherche Médical (INSERM) Unité 914, Faculté de Médecine et Université Paris Sud, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France. nordmann.patrice@bct.aphp.fr
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Walsh
authors.forename: David M
authors.initials: DM
authors.lastname: Livermore
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism*; D015780:Carbapenems / Q000494:pharmacology*; D004196:Disease Outbreaks; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D022761:Gene Transfer, Horizontal; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology*; D006801:Humans; D010957:Plasmids; D011549:Pseudomonas / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D014737:Vibrionaceae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism*
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase