Increased frequency of blaNDM in a tertiary care hospital in southern Brazil

Resistance to carbapenems due to metallo-beta-lactamase NDM-1 was first described in Brazil in 2013. To date, only a few scattered reports of the prevalence of NDM-1 in the country have been reported, and most of them indicated a very low prevalence of this metalloenzyme. In the present study, we report a steady increase in the frequency of NDM among Enterobacterales resistant to carbapenems in a tertiary care hospital in southern Brazil. Carbapenemase genes were evaluated by multiplex real-time polymerase chain using high-resolution melting analysis among 3501 isolates of 8 different species of Enterobacterales recovered from January 2015 to May 2020. The bla(KPC-like) was identified in 3003 isolates (85.8%) and the bla(NDM-like) was the second most common gene (351 isolates-10%). There was a steady increase in frequency of bla(NDM-like), from 4.2% in 2015 to 24% in 2020. The increase of bla(NDM) frequency raises an important matter as novel therapeutic options are currently very limited for the treatment of patients infected by bacteria carrying the bla(NDM).

Automated summary

There has been a steady increase in the frequency of NDM among Enterobacterales resistant to carbapenems in a tertiary care hospital in southern Brazil. The second most common carbapenemase gene, bla(NDM-like), increased from 4.2% in 2015 to 24% in 2020, posing a significant challenge for treatment options.