<i>Notes from the Field</i>: Increase in New Delhi Metallo-β-Lactamase–Producing Carbapenem-Resistant Enterobacterales — New York City, 2019–2024
Katelynn Devinney, Nicole Burton, Karen A. Alroy, Addie Crawley, Cherry-Ann Da Costa-Carter, Molly M Kratz, Ying Lin, Jorge M. Montfort-Gardeazabal, Thomas Portier, Celina Santiago, Ulrike Siemetzki-Kapoor, Matthew Sullivan, Rain J. Wiegartner, Tristan D. McPherson, William Greendyke
Abstract
Enterobacterales comprise a large group of gram-negative bacteria, including Escherichia coli and Klebsiella species; infections with these organisms often require treatment with a class of broad-spectrum antibiotics known as carbapenems.Numerous mechanisms can result in the emergence of carbapenem-resistant Enterobacterales (CRE), including the production of enzymes (carbapenemases) that render the antibiotics ineffective in killing bacteria.CRE cause health care-associated infections resulting in substantial morbidity and mortality; carbapenemase-producing CRE are particularly concerning because carbapenemase genes are easily spread via plasmid-mediated genetic elements.*Klebsiella pneumoniae carbapenemase (KPC) has been the predominant carbapenemase among Enterobacterales in the United States since 1996 (1).Another carbapenemase, New Delhi metallo--lactamase (NDM), is less common in the United States, confers resistance to antimicrobials commonly used to treat KPC-positive CRE (e.g., the combination antibiotic ceftazidime-avibactam) (2), and has previously been associated with returning international travelers (3).The prevalence of NDM-positive CRE has increased in New York City (NYC) health care settings, including long-term care facilities (LTCFs) (4).The NYC Health Department observed a notable and sustained increase in NDM-positive CRE cases from 2019 to 2024, indicating that local treatment recommendations might need to be modified in response to changing carbapenemase epidemiology.This report describes trends in carbapenemase epidemiology in NYC during 2019-2024.