Hemant J Vira and Vivek G Bhat
Infectious diseases are a major cause of morbidity and mortality throughout the world. Cancer patients are immunocompromised due to the disease itself and also due to multiple factors such as chemotherapy, radiotherapy, impairment of normal leukocyte function, and use of corticosteroids. This leads to development of resistant pathogens in them of which the New Delhi metallo-β-lactamase-1 (NDM-1) is mostly resistant to the drug of last resort the class of carbapenems. The increase in extended spectrum carbapenem resistance class of antibiotic has led to a worldwide need for a development of a more efficient and novel class of drug active against NDM-1 producing gram-negative bacteria. The epidemiological study of NDM-1 gene has revealed a startling fact on the widespread prevalence of extended spectrum carbapenem resistant gram-negative bacteria in cancer patients both nationally and internationally. Pharmacovigilance and formulations of different class of antibiotics are needed to tackle the problem of this widespread resistance. The various drug delivery methods and drug designing platforms are needed for the development of a novel class of drug needed to efficiently eradicate these multidrug resistant gram-negative pathogens. In the present review, we have described the epidemiological prevalence of NDM-1 and its variants producing gram negative bacilli in cancer patients both nationally and internationally, the problem of ineffectiveness of carbapenem class of antibiotics against such pathogens, and also the future line of developments needed in the field of pharmacovigilance and pharmacotherapeutics to develop a highly efficient, target specific, and cost-effective class of antibiotics.
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