New Delhi metallo-beta-Lactamase-1 (NDM-1) containing bacteria: Special Biosafety Notification
This Special Biosafety Notification is being provided by the Public Health Agency of Canada in response to the recent scientific publication on bacteria containing New Delhi metallo-beta-Lactamase-1 (NDM-1). This notification is based on current available scientific evidence about this emerging beta-Lactamase and is subject to review and change as new information becomes available.
Bacteria containing the novel NDM-1 have shown broad antibiotic resistance1. Clinical isolates were first identified in India, Pakistan and the UK however, unpublished cases have been found in other countries including Canada1,2. Currently, the isolates identified in Canada have originated from the above mentioned countries.
Studies have shown that the NDM-1 enzyme may be easily transferred between different genera of the Enterobacteriaceae family1. In these studies, NDM-1 has been identified in the following genera or species, which should be considered possible carriers, especially if the clinical samples are of Indian or Pakistani origin: Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., (particularly Enterobacter cloacae), Proteus spp., Citrobacter freundii, Klebsiella oxytoca, Morganella morganii, and Provendencia spp.
The Pathogen Regulation Directorate (formerly the Office of Laboratory Security) has determined that the suspected or confirmed presence of NDM-1 does not change the containment requirements for the originating bacteria.
Due to the antibiotic resistant properties of the NDM-1enzyme, we would like to emphasize some of the critical operational practices taken from the Laboratory Biosafety Guidelines3 in order to limit the potential spread of the NDM-1enzyme.
- Laboratory personnel must wear the appropriate protective laboratory clothing when entering/working in the laboratory.
- Gloves must be worn for all procedures that might involve direct contact with biohazardous material or infected animals.
- Hands must be washed 1) after gloves have been removed 2) before leaving the lab and 3) after handling materials known/suspected to be contaminated.
- The use of a certified Biological Safety Cabinet (BSC) is required for procedures that may produce infectious aerosols* and that involve high concentrations or large volumes of infectious material. If no BSCs are available, operational practices and techniques must be used to minimize the creation of aerosols. [* BSC use is mandatory for all work with E.coli O157:H7].
- All contaminated liquid and solid materials must be appropriately decontaminated before disposal, reuse or removal from the laboratory.
- Laboratory bench tops and surfaces must be decontaminated with appropriate disinfectant when work is complete and after any spill of infectious materials.
- Packaging, shipping and transport of infectious substances must comply with the requirements of the Transportation of Dangerous Goods Act and Regulations4. (For further information on how to receive training and certification in the Transportation of Dangerous Goods, please contact the Laboratory Safety Office at firstname.lastname@example.org or contact on the 24/7 emergency phone line at 613-292-6754.)
Further biosafety information may be obtained from the Pathogen Regulation Directorate, Centre for Emergency Preparedness and Response, Public Health Agency of Canada at (613) 957-1779, fax (613) 941-0596, email biosafety_biosécurité@phac-aspc.gc.ca or web site
- Kumarasamy KK, et al (2010) Emergence of new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet 1-6.
- Pittout JDD (2010) The latest threat in the war on antimicrobial resistance. Lancet (online ahead of print): 1-2.
- Laboratory Biosafety Guidelines, 3rd Edition, 2004, Public Health Agency of Canada
- Transport Dangerous Goods (External link) , Transport Canada
- Containment Standards for Veterinary Facilities, 1st edition, 1996 (External link) , Agriculture and Agri-Food Canada
- Material Safety Data Sheets, Public Health Agency of Canada
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