The W-5 of NDM-1: The Pinnacle of Antimicrobial Resistance

The prevention of the spread of NDM-1 as a resistance trait is no easy task. The fundamental processes for the control of antimicrobial resistance have been outlined many times and include surveillance, infection prevention and control and antimicrobial stewardship.

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Key Points

• NDM-1 is an enzyme that confers resistance to one of the most potent classes of antibiotics, known as carbapenems plus all other currently available β-lactam antimicrobials.
• The NDM-1 resistance pattern is on a set of genes that can easily move from one bacterium to another.
• The NDM-1 resistance gene has demonstrated its capacity to move into bacteria which carry many other resistance patterns.
• This new resistance pattern has been reported in many different types of commonly encountered bacteria such as Escherichia coli and Klebsiella pneumoniae in addition to pathogenic bacteria such as Salmonella and Vibrio species.
• The presence of NDM-1 along with other resistance traits has rendered some bacteria pan-resistant.
• There is no significant new antimicrobial drug development.

• Environmental contamination, potentially high reservoirs of carriage of NDM-1, and population mobility may be additive factors in the globalization of the public health threat of this antimicrobial resistance pattern.

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