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ARCHIVED - New Delhi metallo-beta-Lactamase (NDM-1)

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New Delhi metallo-beta-Lactamase (NDM-1) is an enzyme that is produced by certain bacteria, making them resistant to most antibiotics. Infections caused by bacteria that produce NDM-1 are more difficult to treat.

What is NDM-1?

New Delhi metallo-beta-Lactamase (NDM-1) is an enzyme that is produced by certain bacteria, making them resistant to most antibiotics.

NDM-1 has been found in many different species of bacteria including Klebsiella and E.coli bacteria, which are frequent causes of healthcare-associated pneumonia and urinary tract infections. 

How do people become infected?

Most people who become infected with bacteria that produce NDM-1 acquire it while in hospital settings.

Similar to other bacteria that cause healthcare-associated infections, the types of bacteria associated with NDM-1 can be spread when proper infection prevention practices are not followed.  Bacteria can spread from patient to patient through the hands of healthcare workers and occasionally through contact with contaminated equipment. This is why proper infection prevention practices, such as frequent hand washing with soap and water or frequent use of alcohol-based hand cleansers, is important in hospital settings.

Who is at risk of infection?

Current data indicate that patients who received medical care in hospitals in either India or Pakistan are the most at risk of acquiring bacteria that produce NDM-1

As with any healthcare-associated infection, particular attention should be given to the elderly, young children and people with weakened immune systems since they are usually at higher risk of developing severe illness from multiple drug-resistant microorganisms.

How much of a concern is NDM-1 to Canadians?

Generally, the public health risk to Canadians is very low. Many of the Canadian cases have acquired their infections in hospital settings while undergoing medical treatment in India or Pakistan. With these Canadian cases, there is no evidence of any further spread of the infections within Canada.

NDM-1 has been found in many different species of bacteria including Klebsiella and E.coli bacteria, which are frequent causes of healthcare-associated pneumonia and urinary tract infections.  If patients develop infections with bacteria that produce NDM-1, the infections will be difficult to treat as the bacteria are resistant to most antibiotics. 

Some people are more susceptible to complications from illness than others. The elderly, young children and people with weakened immune systems are groups that often are at higher risk of developing severe illness from an infection.

Antibiotic resistance is a very important public health concern, and an infection that is resistant to antibiotic treatment can be dangerous.

What are the treatment options for infections that become resistant to antibiotics?

There are many types of antibiotics that fight many types of infections. When an infection fails to respond to one type of antibiotic treatment, another type of antibiotic may successfully fight the infection.

As with all infections, including those that are resistant to antibiotics and those with the NDM-1 enzyme, patients should undergo treatment under the supervision of a physician. The physician will explore the best treatment options suited for the individual and the type of infection.  

How can people protect themselves?

Proper hand hygiene is always important. To decrease the risk of patient-to-patient transmission of any bacteria within healthcare settings, it is particularly important to ensure that people wash their hands frequently with soap and water or frequently use alcohol-based hand cleansers.

What is the Public Health Agency of Canada’s role with healthcare-associated infections?

The Public Health Agency of Canada (PHAC) provides a series of infection control guidelines to hospitals designed to limit the spread of healthcare-associated infections.  PHAC recommends that healthcare facilities follow these guidelines along with relevant provincial and territorial legislation, regulations, and policies. 

Provinces and territories are not required to report cases of NDM-1 to PHAC; however PHAC encourages hospitals to report healthcare-associated infections to their province or territory.  PHAC coordinates the Canadian Nosocomial Infection Surveillance Program, which is a nationwide surveillance system involving more than 50 hospitals in 9 provinces that is designed to identify and track healthcare-associated infections.