New Delhi metallo-β-lactamase 1 (NDM-1)

The Lancet Infectious Diseases, Early Online Publication, 11 August 2010



Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study


Characterization of a New Metallo-β-Lactamase Gene, blaNDM-1, and a Novel Erythromycin Esterase Gene Carried on a Unique Genetic Structure in Klebsiella pneumoniae Sequence Type 14 from India



National Resistance Alert 3 addendum in UK:


*These organisms mostly are resistant to ALL antibiotics except polymyxins and, less consistently, tigecycline.

From Wikipedia

The following antibiotics are inactivated by the enzyme ND Metallo-beta-lactamase (NDM-1):

• cephalosporins
• penicillins
• carbapenem

Beta-lactamase

• 1 Penicillinase
• 2 Classification of Beta Lactamase
  • 2.1 Functional Classification^[2]
    • 2.1.1 Group 1
    • 2.1.2 Group 2
    • 2.1.3 Group 3
    • 2.1.4 Group 4
  • 2.2 Molecular Classification
• 3 Resistance in Gram-negative bacteria
  • 3.1 Extended-spectrum beta-lactamase (ESBL)
    • 3.1.1 Types
    • 3.1.2 TEM beta-lactamases (class A)
    • 3.1.3 SHV beta-lactamases (class A)
    • 3.1.4 CTX-M beta-lactamases (class A)
    • 3.1.5 OXA beta-lactamases (class D)
    • 3.1.6 Others
    • 3.1.7 Treatment
  • 3.2 Inhibitor-resistant β-lactamases
  • 3.3 AmpC-type β-lactamases (Class C)
  • 3.4 Carbapenemases
    • 3.4.1 IMP-type carbapenemases (one of the metallo-β-lactamases)
    • 3.4.2 VIM (Verona integron-encoded metallo-β-lactamase)
    • 3.4.3 OXA (oxacillinase) group of β-lactamases (Class D)
    • 3.4.4 KPC (K. pneumoniae carbapenemase) (Class A)
    • 3.4.5 CMY (Class C)
    • 3.4.6 SME, IMI, NMC and CcrA
    • 3.4.7 NDM-1 (New Delhi metallo-β-lactamase)
• 4 Treatment of ESBL/AmpC/carbapenemases
  • 4.1 General Overview
  • 4.2 According to genes
    • 4.2.1 ESBLs
    • 4.2.2 Inhibitor-Resistant β-Lactamases
    • 4.2.3 AmpC
    • 4.2.4 Carbapenemases
  • 4.3 According to Species
    • 4.3.1 Escherichia coli or Klebsiella
    • 4.3.2 Pseudomonas aeruginosa