On September 9, 2010, according to the Communicable Disease Control Act, the Taiwan Centers for Disease Control (Taiwan CDC) promulgated the inclusion of New Delhi metallo-β-lactamase 1 Enterobacteriaceae infection (NDM-1 Enterobacteriaceae infection) in the list of Category IV Notifiable Infectious Disease in order to require medical institutes and personnel to report such cases and provide a basis for implementing control measures for public health emergency.Although no confirmed case of NDM-1 Enterobacteriaceae infection has been identified in Taiwan, clinicians are required to report NDM-1 Enterobacteriaceae infection within 24 hours of diagnosis according to the case definition below and collect specimen from the patient for testing at the Taiwan CDC’s laboratory for identification in order to prevent possible transmission of the disease.
The following case definition should be used to report confirmed cases of NDM-1 Enterobacteriaceae :
1. Clinical characteristics (An illness that has all of the following characteristics):
I. Presence of infection, especially in patients who have had hospital treatment, including invasive and surgical procedures.
II. Suspected cases of NDM-1 Enterobacteriaceae.
2. Epidemiological characteristics (An illness that has any one of the following characteristics):
I. Patients who had traveled abroad during the past six months, especially to countries such as India and Pakistan.
II. Patients who have not had hospital treatment overseas, but have had contact with suspected cases of NDM-1 Enterobacteriaceae when receiving hospital treatment.
3. Laboratory characteristics:
Detection of Carbapenem resistance in enterobacteriaceae isolated from the patient’s specimen.
4. Case definition: A case that meets the above-mentioned clinical, epidemiological and laboratory characteristics.
5. Clinicians must report cases that meet the aforementioned characteristics within 24 hours of diagnosis.Specimen from the cases must be collected and submitted to Taiwan CDC for final identification.Clinicians are also welcome to report cases that meet only the clinical and epidemiological characteristics but could not be verified for drug resistance to the health authorities.