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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 an 82-year-old man.
The patient, with good past health, is a Hong Kong resident but a frequent traveller to the Mainland China. He travelled to the Mainland on January 6 and was staying at his home there.
He was found unconscious at his home by his neighbour on February 6. He was admitted to a Mainland hospital on the same day. After admission, he was found to have a wound on his occipital area.
He was transferred to Hong Kong for further management and was admitted to Tuen Mun Hospital on February 11. On admission, he was noted to have fever. The diagnosis was aspiration pneumonia.
His sputum collected on February 17 was positive for NDM Carbapenemase producing Enterobacteriaceae.
The patient is currently in stable condition. Investigation is underway.
This is the sixth detection of NDM Carbapenemase producing Enterobacteriaceae in Hong Kong.
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/Saturday, February 25, 2012
Issued at HKT 14:32
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