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Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics

Since the first New Delhi metallo-beta-lactamase (NDM) report in 2009, NDM has spread globally causing various types of infections. NDM-positive organisms produce in vitro resistance phenotypes to carbapenems and many other antimicrobials. It is thus surprising that the literature examining clinical...

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Autores principales: Zmarlicka, Monika T, Nailor, Michael D, Nicolau, David P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554481/
https://www.ncbi.nlm.nih.gov/pubmed/26345624
http://dx.doi.org/10.2147/IDR.S39186
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author Zmarlicka, Monika T
Nailor, Michael D
Nicolau, David P
author_facet Zmarlicka, Monika T
Nailor, Michael D
Nicolau, David P
author_sort Zmarlicka, Monika T
collection PubMed
description Since the first New Delhi metallo-beta-lactamase (NDM) report in 2009, NDM has spread globally causing various types of infections. NDM-positive organisms produce in vitro resistance phenotypes to carbapenems and many other antimicrobials. It is thus surprising that the literature examining clinical experiences with NDM does not report corresponding poor clinical outcomes. There are many instances where good clinical outcomes are described, despite a mismatch between administered antimicrobials and resistant in vitro susceptibilities. Available in vitro data for either monotherapy or combination therapy does not provide an explanation for these observations. However, animal studies do begin to shed more light on this phenomenon. They imply that the in vivo expression of NDM may not confer clinical resistance to all cephalosporin and carbapenem antibiotics as predicted by in vitro testing but other resistance mechanisms need to be present to generate a resistant phenotype. As such, previously abandoned therapies, particularly carbapenems and beta-lactamase inhibitor combinations, may retain utility against infections caused by NDM producers.
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spelling pubmed-45544812015-09-04 Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics Zmarlicka, Monika T Nailor, Michael D Nicolau, David P Infect Drug Resist Review Since the first New Delhi metallo-beta-lactamase (NDM) report in 2009, NDM has spread globally causing various types of infections. NDM-positive organisms produce in vitro resistance phenotypes to carbapenems and many other antimicrobials. It is thus surprising that the literature examining clinical experiences with NDM does not report corresponding poor clinical outcomes. There are many instances where good clinical outcomes are described, despite a mismatch between administered antimicrobials and resistant in vitro susceptibilities. Available in vitro data for either monotherapy or combination therapy does not provide an explanation for these observations. However, animal studies do begin to shed more light on this phenomenon. They imply that the in vivo expression of NDM may not confer clinical resistance to all cephalosporin and carbapenem antibiotics as predicted by in vitro testing but other resistance mechanisms need to be present to generate a resistant phenotype. As such, previously abandoned therapies, particularly carbapenems and beta-lactamase inhibitor combinations, may retain utility against infections caused by NDM producers. Dove Medical Press 2015-08-24 /pmc/articles/PMC4554481/ /pubmed/26345624 http://dx.doi.org/10.2147/IDR.S39186 Text en © 2015 Zmarlicka et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Zmarlicka, Monika T
Nailor, Michael D
Nicolau, David P
Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics
title Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics
title_full Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics
title_fullStr Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics
title_full_unstemmed Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics
title_short Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics
title_sort impact of the new delhi metallo-beta-lactamase on beta-lactam antibiotics
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554481/
https://www.ncbi.nlm.nih.gov/pubmed/26345624
http://dx.doi.org/10.2147/IDR.S39186
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