Increased frequency of blaNDM in a tertiary care hospital in southern Brazil

Resistance to carbapenems due to metallo-beta-lactamase NDM-1 was first described in Brazil in 2013. To date, only a few scattered reports of the prevalence of NDM-1 in the country have been reported, and most of them indicated a very low prevalence of this metalloenzyme. In the present study, we report a steady increase in the frequency of NDM among Enterobacterales resistant to carbapenems in a tertiary care hospital in southern Brazil. Carbapenemase genes were evaluated by multiplex real-time polymerase chain using high-resolution melting analysis among 3501 isolates of 8 different species of Enterobacterales recovered from January 2015 to May 2020. The bla(KPC-like) was identified in 3003 isolates (85.8%) and the bla(NDM-like) was the second most common gene (351 isolates-10%). There was a steady increase in frequency of bla(NDM-like), from 4.2% in 2015 to 24% in 2020. The increase of bla(NDM) frequency raises an important matter as novel therapeutic options are currently very limited for the treatment of patients infected by bacteria carrying the bla(NDM).