We’ve been following the
emergence and global spread of the New Dehli metallo-beta-lactamase (NDM-1). The
latest chapter of that story came out today in Lancet Infectious Diseases, in a fine example of the newly named field of
pharmacoecomicrobiology (say
that three times fast!). Tim Walsh and colleagues sampled tap water and wastewater from the epicenter (New Dehli) and from Cardiff, UK. They found NDM-1 positive bacteria in 4% of drinking water samples and 30% of wastewater samples in New Delhi, but none in Cardiff. More alarmingly, they found this highly mobile resistance gene in a wide array of pathogenic bacteria. In addition to the
Enterobacteriaceae (in which it has already been described), they found stable carriage of NDM-1 encoding plasmids in
Aeromonas,
Shigella and
Vibrio cholera. Susceptibility testing confirmed phenotypic expression, revealing resistance to broad spectrum cephalosporins and carbapenems. On one hand, this is quite predictable (and furthermore, we know that even short-term visitors to an area of endemic resistance for gut bacteria will
carry that resistant flora back home). On the other hand, it speaks to the inevitability of our new post-antibiotic era. This era has already begun, and will proceed incrementally as we see the steady loss of antibiotic classes we once referred to as
“last-resort”.
We’ve been following the emergence and global spread of the New Dehli metallo-beta-lactamase (NDM-1). The latest chapter of that story came out today in Lancet Infectious Diseases, in a fine example of the newly named field of pharmacoecomicrobiology (say that three times fast!). Tim Walsh and colleagues sampled tap water and wastewater from the epicenter (New Dehli) and from Cardiff, UK. They found NDM-1 positive bacteria in 4% of drinking water samples and 30% of wastewater samples in New Delhi, but none in Cardiff. More alarmingly, they found this highly mobile resistance gene in a wide array of pathogenic bacteria. In addition to the Enterobacteriaceae (in which it has already been described), they found stable carriage of NDM-1 encoding plasmids in Aeromonas, Shigella and Vibrio cholera. Susceptibility testing confirmed phenotypic expression, revealing resistance to broad spectrum cephalosporins and carbapenems. On one hand, this is quite predictable (and furthermore, we know that even short-term visitors to an area of endemic resistance for gut bacteria will carry that resistant flora back home). On the other hand, it speaks to the inevitability of our new post-antibiotic era. This era has already begun, and will proceed incrementally as we see the steady loss of antibiotic classes we once referred to as “last-resort”.
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