New Delhi Metallo-beta-lactamase around the world: an eReview using Google Maps

Euro Surveill. 2014 May 22;19(20):20809. doi: 10.2807/1560-7917.es2014.19.20.20809.


Gram-negative carbapenem-resistant bacteria, in particular those producing New Delhi Metallo-betalactamase-1 (NDM-1), are a major global health problem. To inform the scientific and medical community in real time about worldwide dissemination of isolates of NDM-1-producing bacteria, we used the PubMed database to review all available publications from the first description in 2009 up to 31 December 2012, and created a regularly updated worldwide dissemination map using a web-based mapping application. We retrieved 33 reviews, and 136 case reports describing 950 isolates of NDM-1-producing bacteria. Klebsiella pneumoniae (n= 359) and Escherichia coli (n=268) were the most commonly reported bacteria producing NDM-1 enzyme. Several case reports of infections due to imported NDM-1 producing bacteria have been reported in a number of countries, including the United Kingdom, Italy, and Oman. In most cases (132/153, 86.3%), patients had connections with the Indian subcontinent or Balkan countries. Those infected were originally from these areas, had either spent time and/or been hospitalised there, or were potentially linked to other patients who had been hospitalised in these regions. By using Google Maps, we were able to trace spread of NDM-1-producing bacteria. We strongly encourage epidemiologists to use these types of interactive tools for surveillance purposes and use the information to prevent the spread and outbreaks of such bacteria.

Publication types

  • Review

MeSH terms

  • Animals
  • Disease Outbreaks / prevention & control*
  • Gram-Negative Bacteria / enzymology*
  • Humans
  • beta-Lactamases*


  • beta-Lactamases
  • beta-lactamase NDM-1