[Source: Centre for Health Protection, Hong Kong PRC SAR, full text: (LINK).]

Case of NDM-4 Carbapenemase-producing Enterobacteriaceae under CHP investigation

The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) of the Department of Health confirmed today (September 9) a case of New Delhi metallo-β-lactamase-4 (NDM-4) Carbapenemase-producing Enterobacteriaceae in a 7-year-old boy.

The patient, with good past health, lives in Hong Kong. He travelled to India from July 24 to August 29 during which he underwent a foot operation in a local hospital. He returned to Hong Kong on August 29 and was admitted to Princess Margaret Hospital for foot swelling on August 31. His condition has been stable all along and he was discharged home on September 3.

The patient's rectal swab yielded NDM-4 Carbapenemase-producing Enterobacteriaceae as confirmed by the PHLSB.

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

This is the 33rd 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.

Ends/Monday, September 9, 2013
Issued at HKT 19:27