title: Worldwide dissemination of the NDM-type carbapenemases in Gram-negative bacteria.
abstract: The emergence of one of the most recently described carbapenemases, namely, the New Delhi metallo-lactamase (NDM-1), constitutes a critical and growingly important medical issue. This resistance trait compromises the efficacy of almost all lactams (except aztreonam), including the last resort carbapenems. Therapeutical options may remain limited mostly to colistin, tigecycline, and fosfomycin. The main known reservoir of NDM producers is the Indian subcontinent whereas a secondary reservoir seems to have established the Balkans regions and the Middle East. Although the spread of bla NDM-like genes (several variants) is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified in P. aeruginosa and Acinetobacter spp. Acinetobacter sp. may play a pivotal role for spreading bla NDM genes for its natural reservoir to Enterobacteriaceae. Rapid diagnostic techniques (Carba NP test) and screening of carriers are the cornerstone to try to contain this outbreak which threatens the efficacy of the modern medicine.
authors.affiliation: INSERM U914 "Emerging Resistance to Antibiotics", 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Dortet
authors.affiliation: INSERM U914 "Emerging Resistance to Antibiotics", 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France ; Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, 3 Rue Albert Gockel, 1700 Fribourg, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.affiliation: INSERM U914 "Emerging Resistance to Antibiotics", 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France ; Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, 3 Rue Albert Gockel, 1700 Fribourg, Switzerland.
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000382:microbiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D014943:Global Health / Q000706:statistics & numerical data; D006090:Gram-Negative Bacteria / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases; C552864:beta-lactamase NDM-1