First Report of New Delhi Metallo-β-Lactamase Carbapenemase–Producing Acinetobacter baumannii in Peru

Health-care–associated infections (HAI) and antimicrobial resistance are of great public health concern worldwide.1 Bacterial pathogens causing HAI have become increasingly more resistant over the past 10–15 years as a result of various mechanisms, including gene-mediated enzymes such as class A, B, and D β-lactamases.2 Numerous factors, from the horizontal transfer of gene-encoded enzymes to global travel, have allowed resistance and resistant organisms to rapidly spread with great clinical and epidemiological impact.3,4 The recently described carbapenemase, New Delhi metallo-β-lactamase (NDM-1) class B, is of particular epidemiological and clinical concern. Since its discovery in 2008, NDM-1 has rapidly spread worldwide and confers resistance to almost all lactams, with the exception of aztreonam, leaving limited therapeutic options against pathogens harboring NDM-1, typically colistin, tigecycline, and fosfomycin.2,5,6 In Latin America, the blaNDM-1 gene was first reported in 2011 from Guatemala and Colombia, and later from Mexico in 2012, Brazil in 2013, and Uruguay in 2013, with all instances from Enterobacteriaceae.5 The blaNDM-1 gene in non-fermentative pathogens was first reported in Latin America from Honduras (Acinetobacter baumannii) and Paraguay (Acinetobacter pittii) in 2012, and later from Brazil (A. baumannii) in 2014, Cuba (Acinetobacter soli) in 2015, Argentina (Acinetobacter junii) in 2016, and Colombia (A. baumannii) in 2017.5–8 In Peru, the first report of blaNDM-1 was in May 2017 in a set of nine Klebsiella pneumoniae infecting or colonizing critically ill neurological patients from one hospital in Lima.9 Here, we describe the identification of the first three strains of A. baumannii harboring blaNDM-1 in Peru as part of a strain-based surveillance project carried out by the Naval Medical Research Unit No Six (NAMRU-6) in Lima, Peru.