Gram-negative bacteria with carbapenem resistance conferred by New Delhi Metallo-²-lactamase-1 (NDM-1) are a major global health problem. To inform the scientific and medical community about worldwide NDM-1 cases, we used the PubMed database to review publications from the first description of NDM-1 in 2009, and created a worldwide dissemination map using a web-based mapping application. In the PubMed database, there were 29 reviews, and 101 case reports describing 709 NDM-1 producing strains from around the world. Klebsiella pneumoniae (n= 292) and Escherichia coli (n=207) were most commonly reported bacteria to carry the NDM-1 gene. It has also been found in Acinetobacter baumannii (n=31), Pseudomonas aeruginosa (n=8) and in a wide variety of Gram-negative species. The first bacteria containing the NDM-1 enzyme were reported in India in 2006. Several imported cases of infections due to NDM-1 producing strains have also been reported in a number of countries, including the United Kingdom, Italy, and Oman. In most of the cases, patients had connections with the Indian Pacific region or the Balkan countries. Those infected were originally from those areas, had spent time there, had been hospitalized there, or they were potentially linked to other patients who had been hospitalized in those regions. To prevent outbreaks of NDM-1 producing strains and to optimize antibiotic therapy, we strongly encourage epidemiologists to utilize these types of interactive tools for surveillance purposes and, more importantly, to communicate these data to other members of the research community and the general public in real time.
Google Map as an interactive tool for surveillance of NDM 1 carbapenemase encoding gene all over the world. map
Table. Summary of papers describing NDM-1positive bacteria, from the first report through June 30, 2012