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Superbug seen in non-prevalent areas

Dec 6, 2012

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In the first report of its kind, Sunnybrook researchers caution that a superbug resistant to almost all available antibiotics — though still rare — is emerging locally in Canada and globally in patients with no travel history linked to medical tourism procedures or hospitalization in prevalent areas.

The study published in Infection Control and Hospital Epidemiology reports on locally acquired NDM1-Kp (New Delhi Metallo-beta-lactamase-1-producing Klebsiella pneumoniae) and identifies risk factors for hospital transmission based on a case-cohort analysis.

NDM-1 is an enzyme that makes bacteria resistant to most drugs including carbapenem antibiotics. When an immune-weakened patient is infected with the organism and becomes ill, this may cause serious urinary tract infections, bloodstream and wound infections or pneumonia. Because these organisms are so highly resistant to available antibiotics, the infections they cause may be very difficult to eradicate.

"Given the concern that locally acquired NDM-1 will become a bigger issue in the not so distant future, we need to gain a better understanding now, of patterns of spread and risk factors, and to gather further evidence of the critical importance of adequate cleaning of the hospital environment in order to prevent transmission of these organisms," says Dr. Andrew Simor, senior scientist, Sunnybrook Research Institute, and Professor, Departments of Medicine, and Laboratory Medicine and Pathobiology, University of Toronto.

Full media release

NDM-1-PRODUCING BACTERIA EMERGING IN NON-PREVALENT AREAS

Toronto,CANADA (November 20, 2012) - In the first report of its kind, Sunnybrook researchers caution that NDM1-Kp (New Delhi Metallo-beta-lactamase-1-producing Klebsiella pneumoniae) a superbug resistant to almost all available antibiotics, though still rare is emerging locally in Canada and globally in patients with no travel history linked to medical tourism procedures or hospitalization in prevalent areas.

The study published in Infection Control and Hospital Epidemiology reports on locally acquired NDM1-Kp and identifies risk factors for hospital transmission based on a case-cohort analysis.

NDM-1 is an enzyme that makes bacteria resistant to most drugs including carbapenem antibiotics.  When an immune-weakened patient is infected with the organism and becomes ill, this may cause serious urinary tract infections, bloodstream and wound infections or pneumonia.    Because these organisms are so highly resistant to available antibiotics, the infections they cause may be very difficult to eradicate. 

"Preventing the spread of NDM-1 in hospitals is critical as there is a lack of effective antibiotics to treat these infections," says Dr. Andrew Simor, lead investigator, and Chief, Microbiology, and Infectious Diseases, Sunnybrook.

"Given the concern that locally acquired NDM-1 will become a bigger issue in the not so distant future, we need to gain a better understanding now, of patterns of spread and risk factors, and to gather further evidence of the critical importance of adequate cleaning of the hospital environment in order to prevent transmission of these organisms," says Dr. Simor, senior scientist, Sunnybrook Research Institute, and Professor, Departments of Medicine, and Laboratory Medicine and Pathobiology, University of Toronto.

The researchers report significant risk factors for hospital transmission based on a case-cohort analysis of 126 patients identified as contacts of patients later identified as NDM-1 positive:

  • history of recent exposure to multiple classes of antibiotics
  • duration of exposure to NDM1-Kp positive patients.

In this analysis, the researchers also defined contacts, and the risk levels associated with a contact being a roommate, wardmate or environmental contact. 

They also highlight the need for further study into appropriate duration and frequency of screening contacts of NDM1-Kp positive patients.

For more information, please contact:

Natalie Chung-Sayers, 416.480-4040, natalie.chung-sayers@sunnybrook.ca

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