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BioMed Research International
Volume 2014 (2014), Article ID 249856, 12 pages
http://dx.doi.org/10.1155/2014/249856
Review Article

Worldwide Dissemination of the NDM-Type Carbapenemases in Gram-Negative Bacteria

1INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
2Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, 3 Rue Albert Gockel, 1700 Fribourg, Switzerland

Received 7 December 2013; Accepted 15 February 2014; Published 26 March 2014

Academic Editor: Karmen Torkar

Copyright © 2014 Laurent Dortet et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The emergence of one of the most recently described carbapenemases, namely, the New Delhi metallo-lactamase (NDM-1), constitutes a critical and growingly important medical issue. This resistance trait compromises the efficacy of almost all lactams (except aztreonam), including the last resort carbapenems. Therapeutical options may remain limited mostly to colistin, tigecycline, and fosfomycin. The main known reservoir of NDM producers is the Indian subcontinent whereas a secondary reservoir seems to have established the Balkans regions and the Middle East. Although the spread of -like genes (several variants) is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified in P. aeruginosa and Acinetobacter spp. Acinetobacter sp. may play a pivotal role for spreading genes for its natural reservoir to Enterobacteriaceae. Rapid diagnostic techniques (Carba NP test) and screening of carriers are the cornerstone to try to contain this outbreak which threatens the efficacy of the modern medicine.