Enterobacterales represent a serious threat to transplant patients due to their increase frequency of carbapenem resistance and wide spreading. We present a case of an infant with acute lymphoblastic leukemia undergoing hematopoietic stem cell transplantation. Before transplantation an unusual double colonization of the gastrointestinal tract with extremely resistant Escherichia coli and Klebsiella pneumoniae strains producing metallo-beta-lactamase was diagnosed. Respective epidemiological management was implemented, based on the strict reverse isolation in patient-protective environment, and intensified antimicrobial surveillance. After granulocyte recovery, no extremely drug-resistant strains were found, and no case of isolation and/or transmission of carbapenem-resistant bacteria has been identified in the transplant center during the following 6 months.
Departments of *Microbiology
†Pediatric Hematology and Oncology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, University Hospital No. 1, Bydgoszcz, Poland
Supported by the Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń with funds from the maintenance of the research potential of the Department of Microbiology.
P.Z.-W.: design of the study, microbiological analysis, interpretation of the results, and writing of the manuscript. K.C.: clinical analysis and interpretation, and writing of the manuscript. T.B.: PCR analysis and interpretation, and critical revision of the manuscript. E.G.-K. and M.W.: critical revision of the manuscript.
The authors declare no conflict of interest.
Reprints: Patrycja Zalas-Więcek, PhD, Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, University Hospital No. 1, 9 M. Skłodowska-Curie Street, 85094 Bydgoszcz, Poland (e-mail: firstname.lastname@example.org).
Received July 1, 2018
Accepted October 18, 2018