EMERGENCE AND CLINICAL IMPACT OF NDM-1
(NEW DELHI METALLO-Β-LACTAMASE-1) IN ESCHERICHIA COLI: MECHANISMS AND THERAPEUTIC CHALLENGES

Lakshmi.S, Anfal Uzma Deenaz, Mangala D N, Saleela, Hithashree M, Keerthana H Bhongale

The increasing lack of effective antibiotics on offer is of particular concern as the resistance of carbapenem can be regarded as one of the most threatening phenomena as carbapenems are often the last resort in most infections. One of the mechanisms of antibiotic resistance that is particularly worrying is the enzyme New Delhi metallo-β-lactamase-1 (NDM-1). As the name implies, this enzyme has great hydrolase activity toward almost all kinds of β-lactam-based antibiotics, including carbapenems. When NDM-1 becomes acquired by the Escherichia coli bacteria, which can be said to be the well-known pathogens that cause community- and nosocomial infections, then treating such strains becomes highly challenging, even impossible using common medicines. The following literature review will be based on the course of evolution and propagation of NDM-1 in E. coli and why this is occurring on the molecular level. Meanwhile, it will comment on the clinical implications of such infections and describe some of the promising streams of research that may lead to some progress in this respect in the future. These instructions consist of combination therapy, metal chelating therapy, bacteriophage use, and drug repurposing. In general, the only thing that we need in order to overcome the challenges posed by NDM-1-driven resistance is the invention of new types of treatment and closer collaboration between scientists from various disciplines.

Keywords – Carbapenem, Escherichia coli, New Delhi metallo-β-lactamase-1