An elderly Ontario man has become the first patient in Canada to become infected by a bug that was made drug-resistant by NDM-1.

The man's case is described by infectious diseases experts in the latest issue of the Canadian Medical Association Journal.

The doctors say they found NDM-1 in the 86-year-old man from Ontario after he was admitted to hospital with a stroke. While doctors were testing his urine, they discovered he had multidrug-resistant bacteria that were later found to be expressing the NDM-1 enzyme.

But the man had no symptoms of a urine infection, and so he was not treated for the infection.

Doctors have no idea how the man acquired the NDM-1, since he hasn't left the province in over 10 years. They found that none of his family or friends had travelled to India either, and all have tested negative for NDM-1 producing organisms, as well.

"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 authors say.

NDM-1 is not a bug as such, but a newly discovered enzyme produced by bacteria that turns the organisms into superbugs that can resist almost all standard antibiotics.

NDM-1, first identified in 2008, is thought to have developed in India or Pakistan, where it is now endemic. It has since been found in a number of countries, including the United States and Canada.

But all the infections found in Canada to date have been in people who had recently travelled to India, Pakistan or Bangladesh.

As well, most of those infected had either E. coli or bacterial pneumonia. But the Ontario man had altogether different bacteria, called Morganella morganii, which can often cause urinary tract infections.

The doctors also describe the case of an older woman with multiple sclerosis who travelled to India to get the "liberation treatment" for CCSVI. She too was found with NDM-1 expressing bacteria in her urine, this time called Providencia Rettgeri. But again, the bacteria were not causing symptoms so she was not treated for the infection.

The cases reveal how far NDM-1 has already spread and that even people who have not travelled to India are becoming infected, say the report's authors. But they note it's clear the bug is not causing widespread problems.

"This is not at all cause for concern in the community at large," Dr. Susan Poutanen, an infectious diseases physician at Mount Sinai Hospital in Toronto who worked on the report, told CTV News.

"We wanted to report this to make sure that it is recognized that patients who have NDM-1 do not necessarily have to have a history of travel to an endemic region, like the Indian subcontinent," she said.

Other experts note that while neither patient described in these case reports developed serious illnesses from their infections with NDM-1-expressing bacteria, doctors and labs stillneed to keep a close eye on these infections.

"It is not on the scale of other serious infections like mrsa or c difficile at this point but the labs have to be prepared to pick this up and it could be easily missed if labs are not prepared," says infectious diseases specialist Dr. Neil Rau.

"We definitely need a lab surveillance system that tracks this carefully so we know what the trend is."