New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe

Euro Surveill. 2010 Nov 18;15(46):19716. doi: 10.2807/ese.15.46.19716-en.

Abstract

Acquired carbapenemases confer extensive antibiotic resistance to Enterobacteriaceae and represent a public health threat. A novel acquired carbapenemase, New Delhi metallo-beta-lactamase 1 (NDM-1), has recently been described in the United Kingdom and Sweden, mostly in patients who had received care on the Indian subcontinent. We conducted a survey among 29 European countries (the European Union Member States, Iceland and Norway) to gather information on the spread of NDM-1-producing Enterobacteriaceae in Europe, on public health responses and on available national guidance on detection, surveillance and control. A total of 77 cases were reported from 13 countries from 2008 to 2010. Klebsiella pneumoniae was the most frequently reported species with 54%. Among 55 cases with recorded travel history, 31 had previously travelled or been admitted to a hospital in India or Pakistan and five had been hospitalised in the Balkan region. Possible nosocomial acquisition accounted for 13 of 77 cases. National guidance on NDM-1 detection was available in 14 countries and on NDM-1 control in 11 countries. In conclusion, NDM-1 is spreading across Europe, where it is frequently linked to a history of healthcare abroad, but also to emerging nosocomial transmission. National guidance in response to the threat of carbapenemase-producing Enterobacteriaceae is available in approximately half of the surveyed European countries. Surveillance of carbapenemase- producing Enterobacteriaceae must be enhanced in Europe and effective control measures identified and implemented.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carbapenems / pharmacology*
  • Child
  • Child, Preschool
  • Disease Notification
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / diagnosis
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / microbiology
  • Europe / epidemiology
  • Guidelines as Topic*
  • Humans
  • Incidence
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Phenotype
  • Polymerase Chain Reaction
  • Population Surveillance
  • Risk Assessment
  • Surveys and Questionnaires
  • Young Adult
  • beta-Lactamases / metabolism*

Substances

  • Carbapenems
  • beta-Lactamases
  • beta-lactamase NDM-1