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A Region-specific Treatment Strategy To Address The Problem Of Drug Resistance By NDM-1-producing Pathogens

Shazi Shakil, Adnan Ahmad, Shams Tabrez, Ghulam M. Ashraf, Aftab A.P. Khan, Adel M. Abuzenadah and Mohammad A. Kamal

New Delhi metallo-β-lactamase (NDM-1) is a serious threat to the existing antibiotic armory, and a potent weapon for bacteria to aid in in their ‘battle’. It has the ability to inactivate all β-lactams, except aztreonam. However, most of the NDM-1-producers also produce aztreonam hydrolysing-β-lactamases, thereby making these pathogens absolutely resistant to all β-lactams. This minireview incorporates a concise update on global epidemiology (2009- 2012) of NDM-1. However, the crux of the discussion is to focus on paucity of clinically useful therapeutic options, and suggest a solution to the drug resistance threat imposed by NDM-1 bacterial enzyme. The manuscript presents a ‘region-specific treatment strategy’ in a lucid flowchart format. The flowchart which lies at the interface of clinical microbiology and bioinformatics is expected to be useful in containing the problem of drug resistance due to NDM- 1-producing bacterial pathogens.