Were all carbapenemases created equal? Treatment of NDM-producing extensively drug-resistant Enterobacteriaceae: a case report and literature review

Infection. 2018 Feb;46(1):1-13. doi: 10.1007/s15010-017-1070-8. Epub 2017 Sep 15.

Abstract

Purpose: There is currently a paucity of published literature focused on the treatment of infections caused by NDM-producing organisms.

Methods: We describe a case of a bacteraemia caused by an extensively drug-resistant (XDR) New Delhi metallo-β-lactamase (NDM)-producing Serratia marcescens and review the treatment options for XDR NDM-producing Enterobacteriaceae.

Results: Infections caused by New Delhi beta-lactamase (NDM)-producing Enterobacteriaceae are becoming increasingly prevalent worldwide. The presence of the enzyme results in multidrug-resistant and extensively drug-resistant phenotypes which often pose a treatment challenge. Despite this challenge, case reports and series have demonstrated good clinical outcomes with numerous treatment options in comparison to infections due to KPC-producing Enterobacteriaceae.

Conclusions: Further good-quality research focused on the treatment of NDM-producing Enterobacteriaceae is warranted.

Keywords: Carbapenemase; Enterobacteriaceae; Extensively drug resistant; New Delhi beta-lactamase (NDM); Treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amikacin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Child
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / physiology
  • Enterobacteriaceae Infections / drug therapy*
  • Female
  • Humans
  • Meropenem
  • Serratia Infections / drug therapy
  • Serratia Infections / microbiology
  • Serratia marcescens / drug effects
  • Serratia marcescens / physiology*
  • Thienamycins / therapeutic use
  • Treatment Outcome
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Amikacin
  • beta-Lactamases
  • beta-lactamase NDM-1
  • Meropenem