Tuesday, May 24, 2011

The NDM-1 mutation and invincible bacteria

Klebsiella pneumoniae
In 2009, a Swedish patient was described (Yong et al) who, while traveling in New Delhi, India, acquired a bacterial infection that was resistant to carbapenems. Carbapenems are considered to be the most powerful class of antibiotics available in medical science. In a world of antibiotic resistant bacterial strains, these medicines are the last line of defense. The bacterial strain infecting the patient was not only resistant to these drugs, but harbored a gene for a previously unknown subroup of metallo-beta-lactamase (MBL), a carbapenemase, on its type 14 complex. The new gene was termed New Delhi metallo-beta-lactamase-1 (NDM-1).

Single resistant bacteria have been around for a long time, but the new gene is found alongside other resistance genes. So far, multiple resistance in the presence of NDM-1 has been found in Klebsiella pneumoniae, giving this strain an ability to withstand nearly all available medical treatments for bacterial infections.

In 2010, NDM-1 was known to be spread throughout India. Bacteria containing the gene also spread to the UK via patients who travel abroad for medical procedures, as well as the United States, Canada, and Australia. The New Delhi gene is becoming a common variant in the bacterial genome, and as of 2010 was found in an estimated 1-3 percent of enterobacteria infections.

Read more about NDM-1, the so-called superbug gene.

NDM-1 has a novel sequence, and likely a novel structure - medicine will likely need something entirely new to fight any infectious bacteria that carry the gene. Does this mean current antibiotics will likely be useless in 10 years? Read more about the background and potential for invincible bacteria.

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