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Review

NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings

Wenjing Wu, Yu Feng, Guangmin Tang, Fu Qiao, Alan McNally, Zhiyong Zong
Wenjing Wu
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China
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Yu Feng
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China
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  • ORCID record for Yu Feng
Guangmin Tang
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China
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Fu Qiao
Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China
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Alan McNally
Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Zhiyong Zong
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, ChinaDepartment of Infection Control, West China Hospital, Sichuan University, Chengdu, ChinaCenter for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China
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DOI: 10.1128/CMR.00115-18
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SUMMARY

New Delhi metallo-β-lactamase (NDM) is a metallo-β-lactamase able to hydrolyze almost all β-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of blaNDM, with certain sequence types (STs) (for K. pneumoniae, ST11, ST14, ST15, or ST147; for E. coli, ST167, ST410, or ST617) being the most prevalent. NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, the Middle East, and the Balkans. Most blaNDM-carrying plasmids belong to limited replicon types (IncX3, IncFII, or IncC). Commonly used phenotypic tests cannot specifically identify NDM. Lateral flow immunoassays specifically detect NDM, and molecular approaches remain the reference methods for detecting blaNDM. Polymyxins combined with other agents remain the mainstream options of antimicrobial treatment. Compounds able to inhibit NDM have been found, but none have been approved for clinical use. Outbreaks caused by NDM-positive strains have been reported worldwide, attributable to sources such as contaminated devices. Evidence-based guidelines on prevention and control of carbapenem-resistant Gram-negative bacteria are available, although none are specific for NDM-positive strains. NDM will remain a severe challenge in health care settings, and more studies on appropriate countermeasures are required.

FOOTNOTES

    • Published 30 January 2019.
  • Supplemental material for this article may be found at https://doi.org/10.1128/CMR.00115-18.

  • Copyright © 2019 American Society for Microbiology.

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NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings
Wenjing Wu, Yu Feng, Guangmin Tang, Fu Qiao, Alan McNally, Zhiyong Zong
Clinical Microbiology Reviews Jan 2019, 32 (2) e00115-18; DOI: 10.1128/CMR.00115-18

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NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings
Wenjing Wu, Yu Feng, Guangmin Tang, Fu Qiao, Alan McNally, Zhiyong Zong
Clinical Microbiology Reviews Jan 2019, 32 (2) e00115-18; DOI: 10.1128/CMR.00115-18
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  • Article
    • SUMMARY
    • INTRODUCTION
    • NDM, A SUBCLASS B1 MBL
    • NDM VARIANTS
    • EPIDEMIOLOGY OF NDM-POSITIVE STRAINS
    • DETECTION METHODS
    • TREATMENT OPTIONS AGAINST NDM-POSITIVE STRAINS
    • INFECTION PREVENTION AND CONTROL FOR NDM-POSITIVE STRAINS
    • CONCLUDING REMARKS
    • ACKNOWLEDGMENTS
    • FOOTNOTES
    • REFERENCES
    • Author Bios
  • Figures & Data
  • Info & Metrics
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KEYWORDS

Acinetobacter
Enterobacteriaceae
NDM
carbapenem resistance
carbapenemase
metalloenzymes

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