CHP detects imported case of NDM-1 producing Enterobacteriaceae
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     The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) has identified an imported case of New Delhi metallo-ß-lactamase 1 (NDM-1) producing Enterobacteriaceae. The patient was a 74-year-old man.

     The man, living in Fujian, developed cough and fever since October 26 and was hospitalised from October 26 to 30. Because of persistent symptoms, the patient returned to Hong Kong on October 30 for medical consultation and was admitted to Princess Margaret Hospital on the same day. He is now in stable condition.

     His rectal swab specimen grew NDM-1 producing Enterobacteriaceae.

     The patient did not have any gastroenteritis symptoms. His home contacts were asymptomatic.

     Investigation is underway and there is presently no sign of spread.

     This is the fifth detection of NDM-1 producing Enterobacteriaceae in Hong Kong.

     The spokesman explained that NDM-1 is an enzyme which can inactivate carbapenems and other beta-lactams such as penicillins. Bacteria harbouring this NDM-1 gene are commonly resistant to multiple antimicrobials, limiting therapeutic options and rendering severe clinical infections difficult to treat. Most bacteria with the NDM-1 enzyme remain susceptible to two types of antibiotics, colistin and tigecycline.

     Infections have varied from being mild 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-1 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-1 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 have had prior hospital contact in the Indian subcontinent.

     The spokesman said that proper use of antibiotics and personal hygiene, especially hand hygiene, are important for the prevention of emergence and cross transmission of NDM strains.

Ends/Saturday, November 5, 2011
Issued at HKT 17:37

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