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The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) has identified a case of New Delhi metallo-£]-lactamase (NDM) Carbapenemase producing Enterobacteriaceae in a 60-year-old man.
The patient, who has underlying medical conditions, presented with bone pain and bilateral lower limb weakness on March 27; he was admitted to Princess Margaret Hospital on the next day. The patient is now in stable condition.
A strain of bacterium harbouring NDM was detected from his rectal swab today (April 7). No outbreak was detected in the ward. His home contacts were asymptomatic.
CHP investigation revealed the patient has recent travel history to the Mainland from March 3 to 27.
A spokesman for CHP said the patient showed no active signs of infection. Investigations are underway and there is presently no sign of spread.
This is the third detection of NDM Carbapenemase producing Enterobacteriaceae in Hong Kong. The first case involved a 66-year-old man in October 2009 while the second case involved a 54-year-old Indian lady in December 2010. The patients have fully recovered.
The spokesman explained that NDM is an enzyme which can inactivate carbapenems and other beta-lactams such as penicillins. Bacteria harbouring this NDM gene are commonly resistant to multiple antimicrobials, limiting therapeutic options and rendering severe clinical infections difficult to treat. Most bacteria with the NDM enzyme remain susceptible to two types of antibiotics, colistin and tigecycline.
Infections have varied from being asymptomatic to potentially life threatening or fatal. The level of risk depends on which part of the body is affected by the infection, and the general health of the patient.
NDM producing Enterobacteriaceae was first reported in a Swedish patient of Indian origin who travelled to New Delhi, India in 2008. The first fatal case was identified in 2010 in a patient who received medical treatment in Pakistan before being repatriated to Belgium.
The NDM producing Enterobacteriaceae has now been reported in many countries and regions including Australia, Austria, Canada, Belgium, France, Germany, Japan, the Netherlands, Norway, Oman, Sweden, Singapore, Taiwan, the UK and the USA. Most patients having had prior hospital contact in the Indian subcontinent.
The spokesman said that proper use of antibiotics and personal hygiene, especially hand hygiene, were important for the prevention of emergence and cross transmission of NDM strains.
Ends/Thursday, April 7, 2011
Issued at HKT 21:07
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