The Taiwan Centers for Disease Control (Taiwan CDC) confirmed the first isolate of NDM-1 Klebsiella pneumoniae in . The case has not developed any symptoms of infection and is considered as having enterobacteriaceae colonization, namely an asymptomatic carrier. The case does not meet the clinical characteristics of NDM-1 enterobacteriaceae infection listed in Category IV Notifiable Infectious Disease.

To strengthen the surveillance of NDM-1 enterobacteriaceae infection in Taiwan, Taiwan CDC has not only monitored occurrence of international outbreaks and promptly established the mechanism for case-reporting and laboratory testing, but also actively paid close attention to the health conditions of the victim from a Taiwanese TV station who was shot and wounded in India and collected specimens from the drain site, urine and rectal swab for bacteria culture and identification. The laboratory test results showed that only rectal swab was culture-positive for carbapenem resistant Klebsiella pneumoniae. NDM-1 gene was detected by PCR and was confirmed by sequencing. This strain was identified as NDM-1 Klebsiella pneumoniae. In light of the fact that the case underwent an abdominal operation and antibiotics treatment in a country at risk for NDM-1 infection, the isolated strain is considered as imported. Currently, the patient has been recovering well and is in good health. Since there is no substantial evidence to recommend decolonization, hospital has permitted his discharge. Taiwan CDC has obtained the patient's consent for him to regularly receive follow-up testing.

Unlike other common infectious diseases that are spread through direct person-to-person contact or droplet transmission, NDM-1 infection occurs mainly through the process of invasive medical treatment such as surgery or wound treatment that could cause opportunistic infection in patients. Additionally, enterobacteriaceae primarily colonized the intestine. As the domestic sanitary sewer system and the tap water supply system in are very well-constructed, there should be little concern for community-acquired outbreak. Furthermore, the case returned to accompanied by a SOS physician. All the medical wastes produced during the journey were brought back by the SOS physician and h as regulated. The seats and toilets used by the case and the accompanying SOS physician in the aircraft have been cleaned and disinfected. Upon arrival, the case was immediately placed in a single isolation ward in a medical center in northern . The hospital staffs and visitors were asked to comply with contact precautions and hand hygiene.

Overuse and misuse of antimicrobials and the spread of resistant organisms among individuals, communities, and countries have made antimicrobial resistance become a serious public health issue worldwide. NDM-1 Enterobacteriaceae is also one of the multidrug-resistant pathogens. To tackle this issue related to antimicrobial resistance (AMR), the World Health Organization (WHO) urged countries to adopt a multifaceted strategy aiming at integrating a number of different actions to reduce AMR. These actions include continuous monitoring, adequate use of antimicrobials by clinical doctors based on the scientific evidence and laboratory findings, adequate use of antimicrobials by the general population in compliance with the doctor’s prescriptions and instructions, and strengthen infection control interventions in hospitals such as contact precautions, hand hygiene, and hospital cleaning and disinfection. To control AMR, Taiwan CDC has formulated the guideline for multidrug-resistant organisms in healthcare settings, which followed the WHO recommendations and related literatures. Moreover, Taiwan CDC has been promoting hand hygiene, conducting infection control inspection of hospitals, and setting up various education programs to facilitate hospitals in controlling AMR and to protect the healthcare workers and the citizens.