A cautionary case of microbial solidarity: concurrent isolation of VIM-1-producing Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae from an infected wound
The emergence and spread of acquired metallo-b-lactamases (MBLs) represents a worldwide problem. In Greek hospitals, the occurrence of MBL producers is currently endemic in Klebsiella pneumoniae, and sporadic among species of Enterobacter and Escherichia coli.1 We report herein the simultaneous recovery of K. pneumoniae, Enterobacter cloacae and E. coli producing VIM-1-type MBL from an infected wound.
The patient was born prematurely with Arnold–Chiari syndrome and duodenal atresia, both corrected surgically. This was complicated by Enterococcus faecium bacteraemia and urinary tract infections [extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae and E. coli]. Antibiotic history included cefuroxime (perioperatively), vancomycin, amikacin and meropenem. Subsequent cultures were negative. However, fever recurred, with breakdown of a dorsal surgical wound. Swab cultures from the exudate yielded K. pneumoniae, E. cloacae and E. coli, which were resistant to carbapenems and susceptible to aztreonam, amikacin, fluoroquinolones and colistin. The three isolates showed an identical susceptibility profile. Blood cultures were negative; a CT scan excluded deep-tissue …....