CHP detects imported case of NDM-1 producing Enterobacteriaceae

The Centre for Health Protection of the department of Health has identified an imported case of New Delhi metallo-beta-lactamase producing Enterobacteriaceae. The patient was a 21-month-old girl.The girl, living in Pok Fu Lam, attended the Accident and Emergency Department of Queen Mary Hospital on July 29 afterdeveloping symptoms including cough, sputum, runny nose, vomiting, loose stool and fever for a few weeks. She was admitted on the same day and was discharged on August 1 in stable condition after treatmentHer stool specimen grew NDM-1 producing Enterobacteriaceae.According to the attending paediatrician, the girl did not have any gastroenteritis symptoms upon discharge. Her home contacts were asymptomatic.The patient travelled between July 1 and 29 to Hunan where she was hospitalised from July 26 to 28 for the treatment of bronchiolitis. Because of persistent symptoms despite treatment, the girl returned to Hong Kong on July 29 for medical consultation. Investigation is under way and there is presently no sign of spread. This is the fourth detection of NDM-1 producing Enterobacteriaceae in Hong Kong.The spokesman explained that NDM-1 is an enzyme that can inactivate carbapenems and other beta-lactams such as penicillins. Bacteria harbouring, this NDM-1 gene are commonly resistant to multiple antimicrobials, limiting therapeutic options and rendering severe clinical infections difficult to treat. Most bacteria with the NDM-1 enzyme remain susceptible to two types of antibiotics, colistin and tigecycline. Infections have varied from mild 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.