Washington, May 31 : Two people in Toronto have reportedly acquired the enzyme associated with extensive antibiotic resistance called the `New Delhi metallo-ß-lactamase-1' (NDM-1).

The enzyme is common in India and Pakistan and is spreading worldwide through travel, medical tourism and its ability to transfer between bacteria.

In one of the two cases, the patient had not travelled outside southwestern Ontario in over a decade and no source could be identified for the organism.

However, in the other case, the patient had been hospitalized in India for a medical procedure and acquired the organism there.

"These two scenarios show that local acquisition of an organism producing NDM-1 has already occurred in Ontario, Canada, that blaNDM-1 has been found in bacterial species other than [Escherichia coli] and [Klebsiella pneumoniae], that treatment options are limited for infections with NDM-1-producing organisms, and that the detection of NDM-1-producing organisms by a laboratory can be difficult," writes Dr. Susan Poutanen, Mount Sinai Hospital and University Health Network with co-authors.

In the case of the patient who had not travelled the author states, "To the best of our knowledge, this is the first reported instance in which an NDM-1-producing organism was locally acquired in Canada."

The report appears in the Canadian Medical Association Journal. (ANI)