TORONTO — Canada now has eight recorded cases of NDM-1 highly drug-resistant superbug infections, up from three cases reported by late August, the Public Health Agency has confirmed.
Four of the patients came from British Columbia, one from Alberta, two from Ontario and one from Quebec, said Dr. Michael Mulvey, chief of Antimicrobial Resistance and Nosocomial Infections at the federal agency.
Two of the four — a 76-year-old B.C. woman and a Quebec patient — died, although not directly from the NDM-1 bacterial infections, Mulvey said.
The B.C. woman, whose case is described in the journal Emerging Infectious Diseases, died from complications of sepsis. The Quebec patient, whose sex was not identified, succumbed to cancer.
At least five of the eight people had travelled to India or Pakistan, where NDM-1 superbug infections are becoming more widespread. Four of those patients spent time in hospital in those countries, and one person had contact with the health-care system.
NDM-1 is an enzyme recently found in several types of bacteria, including some strains of E. coli. NDM-1 — or New Delhi metallo-beta-lactamase — makes the microbes resistant to most, if not all, antibiotics.
The 76-year-old woman had returned to Vancouver in February after spending more than three months in northern India.
She had developed persistent diarrhea while in that country, where she was hospitalized and treated for high blood pressure, congestive heart failure and ongoing diarrhea.
She was treated with antibiotics for a urinary tract infection without success and was transferred back to Canada, where her condition deteriorated in hospital and she died.
Tests showed the woman had contracted strains of E. coli and Klebsiella pneumoniae, both of which contained NDM-1.
“She was a very ill person,” said Mulvey, lead author of the report published Wednesday in the U.S. Centers for Disease Control journal.
Mulvey said the case report is intended as a red flag for the medical community.