Emergence of multidrug-resistant NDM-1-producing Gram-negative bacteria in Bangladesh

Eur J Clin Microbiol Infect Dis. 2012 Oct;31(10):2593-600. doi: 10.1007/s10096-012-1601-2. Epub 2012 Mar 17.


The main objective of this study was to investigate the prevalence of bla (NDM-1) in Gram-negative bacteria in Bangladesh. In October 2010 at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) laboratories, 1,816 consecutive clinical samples were tested for imipenem-resistant Gram-negative organisms. Imipenem-resistant isolates were tested for the bla (NDM-1) gene. Among 403 isolates, 14 (3.5 %) were positive for bla (NDM-1), and the predominant species were Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli. All bla (NDM-1)-positive isolates were resistant to multiple antibiotics. Among β-lactamase genes, bla (CTX-M-1-group) was detected in ten isolates (eight bla (CTX-M-15)), bla (OXA-1-group) in six, bla (TEM) in nine, bla (SHV) in seven, and bla (VIM) and bla (CMY) in two isolates each. The 16S rRNA methylase gene, armA, was detected in five K. pneumoniae isolates and in one E. coli isolate. rmtB and rmtC were detected in a Citrobacter freundii and two K. pneumoniae isolates, respectively. qnr genes were detected in two K. pneumoniae isolates (one qnrB and one qnrS) and in an E. coli isolate (qnrA). Transferable plasmids (60-100 MDa) carrying bla (NDM-1) were detected in 7 of the 11 plasmid-containing isolates. Pulsed-field gel electrophoresis (PFGE) analysis grouped K. pneumoniae isolates into three clusters, while E. coli isolates differed significantly from each other. This study reports that approximately 3.5 % of Gram-negative clinical isolates in Bangladesh are NDM-1-producing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter baumannii / classification
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / genetics
  • Acinetobacter baumannii / isolation & purification
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics
  • Bacterial Typing Techniques
  • Bangladesh / epidemiology
  • Citrobacter freundii / genetics
  • Drug Resistance, Multiple, Bacterial*
  • Electrophoresis, Gel, Pulsed-Field
  • Escherichia coli / classification
  • Escherichia coli / drug effects
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Escherichia coli Proteins / genetics
  • Female
  • Genes, Bacterial
  • Gram-Negative Bacterial Infections / epidemiology*
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Imipenem / pharmacology
  • Infant
  • Klebsiella pneumoniae / classification
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification*
  • Male
  • Methyltransferases / genetics
  • Microbial Sensitivity Tests
  • Middle Aged
  • Plasmids / genetics
  • Prevalence
  • Prospective Studies
  • RNA, Ribosomal, 16S / genetics
  • Young Adult
  • beta-Lactamases / genetics*


  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Escherichia coli Proteins
  • Qnr protein, E coli
  • Qnr protein, Klebsiella pneumoniae
  • RNA, Ribosomal, 16S
  • Imipenem
  • ArmA protein, E coli
  • Methyltransferases
  • beta-Lactamases
  • beta-lactamase NDM-1