Does broad-spectrum beta-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria?

J Antimicrob Chemother. 2011 Apr;66(4):689-92. doi: 10.1093/jac/dkq520. Epub 2011 Jan 28.


The NDM-1 gene, first identified in Sweden in 2008 in Klebsiella pneumoniae from a patient hospitalized in New Delhi, encodes a metallo-β-lactamase that inactivates all β-lactams except aztreonam. This bla(NDM-1) gene has been identified in hospital-acquired bacterial species, such as K. pneumoniae, but also in the typical community-acquired species, Escherichia coli. This gene has been identified in strains that possess other resistance mechanisms contributing to their multidrug resistance patterns. It has been recently extensively reported from the UK, India and Pakistan and, albeit to a lesser extent, from a number of other countries worldwide. In most of the cases a link with the Indian subcontinent has also been established. To stem the onslaught of NDM producers, early identification of cases of NDM-related infections and prevention of their spread by implementing screening, hygiene measures and the isolation of carriers is needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communicable Diseases, Emerging / drug therapy
  • Communicable Diseases, Emerging / epidemiology
  • Communicable Diseases, Emerging / microbiology
  • Disease Transmission, Infectious / prevention & control
  • Escherichia coli / drug effects
  • Escherichia coli / enzymology*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology
  • Humans
  • India / epidemiology
  • Infection Control / methods
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / epidemiology*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / isolation & purification
  • Mass Screening / methods
  • Pakistan / epidemiology
  • Pandemics
  • Sweden / epidemiology
  • United Kingdom / epidemiology
  • beta-Lactam Resistance*
  • beta-Lactamases / biosynthesis*
  • beta-Lactams / pharmacology*
  • beta-Lactams / therapeutic use


  • beta-Lactams
  • beta-Lactamases
  • beta-lactamase NDM-1