Document Detail


Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study.
MedLine Citation:
PMID:  21478057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Not all patients infected with NDM-1-positive bacteria have a history of hospital admission in India, and extended-spectrum β-lactamases are known to be circulating in the Indian community. We therefore measured the prevalence of the NDM-1 gene in drinking water and seepage samples in New Delhi.
METHODS: Swabs absorbing about 100 μL of seepage water (ie, water pools in streets or rivulets) and 15 mL samples of public tap water were collected from sites within a 12 km radius of central New Delhi, with each site photographed and documented. Samples were transported to the UK and tested for the presence of the NDM-1 gene, bla(NDM-1), by PCR and DNA probing. As a control group, 100 μL sewage effluent samples were taken from the Cardiff Wastewater Treatment Works, Tremorfa, Wales. Bacteria from all samples were recovered and examined for bla(NDM-1) by PCR and sequencing. We identified NDM-1-positive isolates, undertook susceptibility testing, and, where appropriate, typed the isolates. We undertook Inc typing on bla(NDM-1)-positive plasmids. Transconjugants were created to assess plasmid transfer frequency and its relation to temperature.
FINDINGS: From Sept 26 to Oct 10, 2010, 171 seepage samples and 50 tap water samples from New Delhi and 70 sewage effluent samples from Cardiff Wastewater Treatment Works were collected. We detected bla(NDM-1) in two of 50 drinking-water samples and 51 of 171 seepage samples from New Delhi; the gene was not found in any sample from Cardiff. Bacteria with bla(NDM-1) were grown from 12 of 171 seepage samples and two of 50 water samples, and included 11 species in which NDM-1 has not previously been reported, including Shigella boydii and Vibrio cholerae. Carriage by enterobacteria, aeromonads, and V cholera was stable, generally transmissible, and associated with resistance patterns typical for NDM-1; carriage by non-fermenters was unstable in many cases and not associated with typical resistance. 20 strains of bacteria were found in the samples, 12 of which carried bla(NDM-1) on plasmids, which ranged in size from 140 to 400 kb. Isolates of Aeromonas caviae and V cholerae carried bla(NDM-1) on chromosomes. Conjugative transfer was more common at 30°C than at 25°C or 37°C.
INTERPRETATION: The presence of NDM-1 β-lactamase-producing bacteria in environmental samples in New Delhi has important implications for people living in the city who are reliant on public water and sanitation facilities. International surveillance of resistance, incorporating environmental sampling as well as examination of clinical isolates, needs to be established as a priority.
FUNDING: European Union.
Authors:
Timothy R Walsh; Janis Weeks; David M Livermore; Mark A Toleman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-07
Journal Detail:
Title:  The Lancet. Infectious diseases     Volume:  11     ISSN:  1474-4457     ISO Abbreviation:  Lancet Infect Dis     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-07-12     Revised Date:  2014-08-15    
Medline Journal Info:
Nlm Unique ID:  101130150     Medline TA:  Lancet Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-62     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Bacteria / drug effects,  enzymology*,  genetics*
Gene Expression Regulation, Bacterial / physiology
Gene Expression Regulation, Enzymologic / physiology
Humans
India / epidemiology
Water Microbiology*
beta-Lactamases / genetics*,  metabolism
Chemical
Reg. No./Substance:
EC 3.5.2.6/beta-Lactamases; EC 3.5.2.6/beta-lactamase NDM-1
Comments/Corrections
Comment In:
Lancet Infect Dis. 2012 Feb;12(2):100-1; author reply 101-2   [PMID:  22281137 ]
Lancet Infect Dis. 2012 Feb;12(2):99; author reply 101-2   [PMID:  22281135 ]
Lancet Infect Dis. 2011 May;11(5):334-5   [PMID:  21478055 ]
Lancet Infect Dis. 2012 Feb;12(2):99-100; author reply 101-2   [PMID:  22281136 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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