Keeping New Delhi metallo-β-lactamase-1 at the door.

New Delhi metallo-β-lactamase-1 is a recently described gene that codes for carbapenem resistance. Inherently transferable between Gram-negative bacteria on a plasmid that also confers extended antibiotic resistance, it represents a potentially serious problem for susceptible patients, such as burn victims, and is spreading globally at a rapid rate. The authors present a case of a septic burn patient returning from India, whose microbiological cultures grew bacteria expressing New Delhi metallo-β-lactamase-1. His TBSA was 14%. His length of stay as an inpatient was 95 days. This is the first case report of this resistance strain from a U.K. burns unit. Isolation, barrier nursing and the use of hydrogen peroxide vapor decontamination proved effective in limiting transmission and spread. The authors are of the opinion that their experience has implications for the management of similar cases in the future.