NDM Metallo-β-Lactamases and their bacterial producers in health care settings

Wenjing Wu, Yu Feng, Guangmin Tang, Fu Qiao, Alan McNally, Zhiyong Zong

Research output: Contribution to journalReview articlepeer-review

119 Citations (Scopus)


New Delhi metallo-β-lactamase (NDM) is a metallo-β-lactamase able to hydrolyze almost all β-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of blaNDM, with certain sequence types (STs) (for K. pneumoniae, ST11, ST14, ST15, or ST147; for E. coli, ST167, ST410, or ST617) being the most prevalent. NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, the Middle East, and the Balkans. Most blaNDM-carrying plasmids belong to limited replicon types (IncX3, IncFII, or IncC). Commonly used phenotypic tests cannot specifically identify NDM. Lateral flow immunoassays specifically detect NDM, and molecular approaches remain the reference methods for detecting blaNDM Polymyxins combined with other agents remain the mainstream options of antimicrobial treatment. Compounds able to inhibit NDM have been found, but none have been approved for clinical use. Outbreaks caused by NDM-positive strains have been reported worldwide, attributable to sources such as contaminated devices. Evidence-based guidelines on prevention and control of carbapenem-resistant Gram-negative bacteria are available, although none are specific for NDM-positive strains. NDM will remain a severe challenge in health care settings, and more studies on appropriate countermeasures are required.

Original languageEnglish
Article numbere00115-18
JournalClinical Microbiology Reviews
Issue number2
Early online date30 Jan 2019
Publication statusPublished - 20 Mar 2019

Bibliographical note

Copyright © 2019 American Society for Microbiology.

Wu W, Feng Y, Tang G, Qiao F, McNally A, Zong Z. 2019. NDM metallo-β-lactamases and their bacterial producers in health care settings. Clin Microbiol Rev 32:e00115-18. https://doi.org/10.1128/CMR.00115-18.


  • Acinetobacter
  • Carbapenem resistance
  • Carbapenemase
  • Enterobacteriaceae
  • Metalloenzymes
  • NDM

ASJC Scopus subject areas

  • Epidemiology
  • Immunology and Microbiology(all)
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases


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