NDM-1 can exist inside different bacteria, like E.coli, and it makes them resistant to one of the most powerful groups of antibiotics - carbapenems. These are generally reserved for use in emergencies and to combat hard-to-treat infections caused by other multi-resistant bacteria. At least one of the NDM-1 infections the Lancet researchers analysed was resistant to all known antibiotics.
Health officials should consider making NDM-1 reportable, says Dr. Susan Poutanen, a medical microbiologist and infectious disease physician at Mount Sinai Hospital in Toronto and author of the study. "We don't have a handle on the exact numbers because it's not currently tracked," she said.
The Public Health Agency of Canada recommends that patients identified as being infected with or colonized by NDM-1 should be treated in single rooms using contact precautions and enhanced environmental cleaning for the duration of their stay in hospital, as well as other steps. Dr. Poutanen reports that European guidelines recommend more precautionary steps.