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CORRESPONDENCE
Year : 2013  |  Volume : 31  |  Issue : 3  |  Page : 319-320
 

NDM-1 producers as causative agents of nosocomial urinary tract infections


1 Department of Microbiology, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani, India
2 Department of General Medicine, Madras Medical College, Chennai, Tamil Nadu, India

Date of Submission10-Mar-2013
Date of Acceptance26-Apr-2013
Date of Web Publication25-Jul-2013

Correspondence Address:
T Menon
Department of Microbiology, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.115674

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How to cite this article:
Menon T, Kumar V N, Sekar M, Princy A. NDM-1 producers as causative agents of nosocomial urinary tract infections. Indian J Med Microbiol 2013;31:319-20

How to cite this URL:
Menon T, Kumar V N, Sekar M, Princy A. NDM-1 producers as causative agents of nosocomial urinary tract infections. Indian J Med Microbiol [serial online] 2013 [cited 2021 Feb 26];31:319-20. Available from: https://www.ijmm.org/text.asp?2013/31/3/319/115674


Dear Editor,

Carbapenem resistant New Delhi metallo-beta-lactamase - 1 (NDM-1) producing gram-negative bacteria have now been reported in several countries world-wide. [1] Some of the cases reported in different parts of the globe have a history of hospitalisation in India. [2] In order to ascertain how frequently NDM-1 producers are isolated from nosocomial infections, we screened isolates collected from patients admitted in the intensive medical care unit of a tertiary care hospital during the period December 2010 to September 2011. A total of 130 specimens were collected, which included urine (n = 72), endotracheal aspirates (n = 41) and blood samples (n = 17). Seventy six strains of gram-negative bacteria, which included enterobacteria; non-fermenters were isolated from these specimens. All isolates were speciated using the standard biochemical tests. [3]

Detection of blaNDM-1 gene was carried out by polymerase chain reaction (PCR) using the primers NDM-Fm (5-GGTTTG GCGATCTGGTTTTC-3) and NDM-Rm (5-CGGAATGGCTCATCACGATC-3), which amplified a 621 bp fragment of the blaNDM-1 gene. [4] Phenotypic tests such as imipenem-ethylenediaminetetraacetic acid double disc synergy test (DDST) and modified Hodge test (MHT) were carried out as described earlier. [5]

Of the 76 isolates, 5 were positive for the blaNDM-1 gene by PCR. PCR products were confirmed by sequencing in all cases. All 5 isolates were from catheterized urine specimens collected from patients with neurological disorders and were resistant to meropenem, ceftazidime and cefipime by disk diffusion tests. They were positive for carbapenem resistance by DDST, but negative by MHT [Table 1].
Table 1: Details of blaNDM-1 positive gram negative bacteria


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There is an urgent need for laboratory protocols, which will rapidly identify carbapenam resistant organisms in hospitalised patients particularly in acute care facilities. In laboratories, where molecular methods are not available, the DDST would serve as a useful screening technique. The fact that these strains were identified in a hospital where carbapenems are infrequently used is a matter of concern and suggests the need for routine surveillance particularly for the detection of unidentified environmental reservoirs.

 
 ~ References Top

1.Poirel L, Lagrutta E, Taylor P, Pham J, Nordmann P. Emergence of metallo-β-lactamase NDM-1-producing multidrug-resistant Escherichia coli in Australia. Antimicrob Agents Chemother 2010; 54:4914-6.  Back to cited text no. 1
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2.Poirel L, Ros A, Carricajo A, Berthelot P, Pozzetto B, Bernabeu S, et al. Extremely drug-resistant Citrobacter freundii isolate producing NDM-1 and other carbapenemases identified in a patient returning from India. Antimicrob Agents Chemother 2011; 55:447-8.  Back to cited text no. 2
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3.Winn WC Jr, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 6 th ed. Philadelphia: Lippincott Williams and Wilkins; 2006.  Back to cited text no. 3
    
4.Nordmann P, Poirel L, Carrër A, Toleman MA, Walsh TR. How to detect NDM-1 producers. J Clin Microbiol 2011;49:718-21.  Back to cited text no. 4
    
5.Lee K, Lim YS, Yong D, Yum JH, Chong Y. Evaluation of the Hodge test and the imipenem-EDTA double-disk synergy test for differentiating metallo-beta-lactamase-producing isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol 2003;41:4623-9.  Back to cited text no. 5
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