New Delhi metallo-β-lactamases among extensively drug-resistant clinical isolates from Lahore, Pakistan

Future Microbiol. 2024;19(11):971-981. doi: 10.1080/17460913.2024.2343600. Epub 2024 Jun 17.

Abstract

Aim: The study determines rates of carbapenem resistance (CR) and frequency of blaNDM in multidrug-resistance (MDR) or extensive drug resistance (XDR), and evaluates the potential of phenotypic tests for detecting NDM production. Materials & methods: Singleplex PCR was used to detect blaNDM. Phenotypic tests, including combination disc test (CDST) and modified Hodge test (MHT), were evaluated for NDM production. Results: Among 338 CR isolates, 47.63% were MDR, whereas 52.36% were XDR with 53.25% carrying blaNDM. MHT was found to be discriminative for detecting NDM production, whereas no significant association was observed for CDST. Conclusion: The high incidence of CR and MDR and XDR isolates possessing blaNDM presents an impending threat in therapeutics. Limitations of phenotypic tests suggest better testing, including molecular detection of the enzyme.

Keywords: carbapenem resistance; extensively drug-resistant (XDR); metallo-β-lactamases (MBL); new delhi metallo-β-lactamase (NDM).

Plain language summary

[Box: see text].

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism
  • Carbapenems / pharmacology
  • Drug Resistance, Multiple, Bacterial* / genetics
  • Humans
  • Microbial Sensitivity Tests*
  • Pakistan / epidemiology
  • beta-Lactamases* / genetics
  • beta-Lactamases* / metabolism

Substances

  • beta-Lactamases
  • Anti-Bacterial Agents
  • beta-lactamase NDM-1
  • Carbapenems
  • Bacterial Proteins