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Hong Kong, Case of NDM-1 Carbapenemase-producing Enterobacteriaceae under CHP investigation (October 16 2013): 34th case, fatal

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  • Hong Kong, Case of NDM-1 Carbapenemase-producing Enterobacteriaceae under CHP investigation (October 16 2013): 34th case, fatal

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

    Case of NDM-1 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 (October 16) a case of New Delhi metallo-β-lactamase-1 (NDM-1) Carbapenemase-producing Enterobacteriaceae in a 25-year-old man.

    The patient, with good past health, lived in Hong Kong. He travelled to Guangdong Province on September 21 and sustained a severe head injury in a traffic accident on September 27. He was admitted to a local hospital and subsequently transferred to Prince of Wales Hospital for further management on October 4. The patient passed away on October 7.

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

    His travel collaterals and home contacts are asymptomatic. The case has been referred to the coroner for further investigation.

    This is the 34th 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/Wednesday, October 16, 2013
    Issued at HKT 12:36