19 September 2012
The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) of the Department of Health has identified a confirmed case of New Delhi metallo-β-lactamase-1 (NDM-1) Carbapenemase producing Enterobacteriaceae in a 64-year-old man.
The patient, with chronic illness, was admitted to Pamela Youde Nethersole Eastern Hospital (PYNEH) on August 17 for shortness of breath and chest pain. He was diagnosed to be suffered from acute coronary syndrome, arrhythmia, sepsis and intestinal obstruction.
He was transferred to Tung Wah Eastern Hospital for rehabilitation on September 7. His current condition is stable.
His rectal swab grew NDM-1 Carbapenemase producing Enterobacteriaceae as confirmed by the PHLSB.
The man has no recent travel history. CHP’s investigation revealed that he had stayed in the same ward in PYNEH where another 78-year-old man with NDM-1 was hospitalised. Further investigation is underway to find out whether there is any linkage between the two cases.
This is the 13th detected case of NDM Carbapenemase producing Enterobacteriaceae in Hong Kong.
The spokesman explained that 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.
The 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.