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Press Release

Case of NDM-1 Carbapenemase-producing Enterobacteriaceae under CHP investigation

3 May 2013

The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) of the Department of Health confirmed today (May 3) a case of New Delhi metallo-β-lactamase-1 (NDM-1) Carbapenemase-producing Enterobacteriaceae in an 84-year-old man.

The man, with an underlying medical condition, travelled to Guangzhou on March 31 and April 1. He was admitted to Queen Mary Hospital for abdominal pain on April 22. He was diagnosed as having acute cholecystitis and was discharged on April 25.

The patient's rectal swab yielded NDM-1 Carbapenemase-producing Enterobacteriaceae as confirmed by the PHLSB.

His family contacts are asymptomatic. Investigations by the CHP are under way.

This is the 27th detected case of NDM Carbapenemase-producing Enterobacteriaceae in Hong Kong.

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.

A CHP 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.

3 May 2013