OBJECTIVES: NDM-1 producing Klebsiella pneumoniae is an increasingly growing health security concern in Pakistan. NDM-1 carrying K. pneumoniae are resistant to several classes of antibiotics used in empiric therapy including the final option antibiotics- carbapenems. In this study possible therapeutic options for the NDM-1 producing K. pneumoniae were explored.

METHODS: Thirty seven isolates already confirmed for the presence of NDM-1 by PCR were included in this study. Kirby-Bauer disc diffusion tests were used for screening the isolates against the three most potent antibiotics; carbapenem, colistin and tigecycline.

RESULTS: All the isolates were resistant to carbapenem, twenty seven resistant to colistin and 11 were resistant to tigecycline.

CONCLUSIONS: Tigecycline is more effective among the three last resort antibiotics, and can be used when none of the antibiotics work against bacteria. Since tigecycline and colistin were effective against the carbapenem resistant isolates, therefore, it is suggested that NDM-1 producing K. pneumoniae should be killed with colistin and tigecycline in combination. However, more research on the double and triple combination of antibiotics is warranted to extend the life of existing antibiotics and ensure health security of the people at large.