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The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) of the Department of Health has identified a case of New Delhi metallo-£]-lactamase-1 (NDM-1) Carbapenemase producing Enterobacteriaceae in a 78-year-old man.
The patient, with underlying illness, was admitted to Pamela Youde Nethersole Eastern Hospital on August 26 for fever, shortness of breath, cough and sputum.
The diagnosis was chest infection and sepsis. His sputum grew Pseudomonas. His condition deteriorated and he died of aspiration pneumonia on September 7.
His urine specimen collected on August 26 also tested positive for NDM-1 Carbapenemase producing Enterobacteriaceae.
Investigation revealed that the man had a history of travel to Myanmar from March 21 to June 24, with hospitalisation in April for treatment of chest infection.
His home contacts had no symptoms of infection.
Investigation by the CHP is continuing.
This is the 11th detected case 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.
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 US. Most patients 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/Monday, September 10, 2012
Issued at HKT 18:23
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