The antibiotic-resistant killer has shown “significant diffusion in the northwestern area of Tuscany” since November 2018, infecting at least 75 people, local health authority ARS said.
The bacterial disease is believed to have killed at least 31 people in 17 different hospitals since then, Italian media reported Thursday.
More than 31 cases were reported in Pisa, home to the famous leaning tower.
Superbug NDM-1 (New Delhi metallo-beta-lactamase 1) sparked a global panic when it was found in the Indian capital in 2010 and showed resistance even to carbapenems, a group of antibiotics often reserved as a last line of defence.
The European Centre for Disease Prevention and Control in June issued a rapid risk assessment after a “large outbreak” of the New Delhi superbug in Tuscany.
It warned of possible cross-border infections, “especially since the affected area is a major tourist destination”.
Tuscany's health authority said “the ability to resist antibiotics makes these bacteria dangerous, especially in vulnerable patients, already affected by serious pathologies or immunosuppressed.”
As a result, hospitals in the region have “stepped up procedures for the prevention and control of infections in health facilities,” it said.
What is NDM-1?
NDM-1 is a genetically determined substance that can make certain types of bacteria resistant to even the strongest known antibiotics. It is not an illness in itself.
It can affect bacteria that cause a range of infections, such as UTIs, sepsis, kidney infections, pneumonia and others, resulting in an infection that does not respond to the usual treatments.
Originally identified in India and Pakistan, NDM-1 superbugs have since been found around the world, carried by people who have travelled through infected areas.
The only known precautions to stop it spreading further are good hygiene, closely monitoring infections and isolating affected patients.
If you're travelling in north-west Tuscany, be sure to wash your hands thoroughly and often, especially before eating or drinking, and seek medical advice immediately if you have symptoms of any type of bacterial infection.