New Delhi Metallo-β-Lactamase, Ontario, Canada

To the Editor: The New Delhi metallo-β-lactamase (NDM-1) was fi rst characterized in 2009 from Kleb-siella pneumoniae and Escherichia coli isolated from a patient in Sweden who had received medical care in New Delhi, India (1). Further studies have shown broad dissemination of this β-lactamase gene (bla NDM-1) in India, Pakistan, Bangladesh, and the United Kingdom (2). Additional isolates have been detected in other countries, and many of the patients with NDM-1– producing Enterobacteriaceae reported receiving medical care in the In-dian subcontinent (1–7). We describe detection and characterization of an NDM-1–producing K. pneumoniae isolated in Ontario, Canada. In August 2010, a urinary tract infection was diagnosed in a 36-year-old woman in a hospital in Brampton, Ontario. An E. coli strain sensitive to multiple antibacterial drugs (including carbapenems) was isolated from a midstream urine sample; the patient was successfully treated with cipro-fl oxacin. One week after treatment, when the patient did not have a fever or other clinical signs, a urine culture was repeated, and a carbapenem-resistant K. pneumoniae isolate (GN529) was recovered. Travel history indicated that the patient had recently returned from India, where in mid-July she had had a miscarriage and had been hospitalized in Mumbai for 2 days. At that time, no antimicrobial drug treatment was prescribed. Susceptibility profi les of K. pneu-moniae GN529 and its E. coli trans-conjugant were obtained by using Etest (bioMérieux, Marcy l'Etoile, France) and the agar dilution method based on the Clinical and Laboratory Standards Institute guidelines (8). Multilocus sequence typing (MLST) of isolate GN529 was performed as described (9). The Pasteur Institute online database