Multiple colonization with highly resistant bacteria: carbapenemase-producing Enterobacteriaceae, carbapenemase-producing Pseudomonas aeruginosa, carbapenemase-producing Acinetobacter baumannii, and glycopeptide-resistant Enterococcus faecium

The dissemination of carbapenemase-producing bacteria worldwide is an important source of concern because carbapenemase producers are multidrug resistant (Nordmann and Poirel, 2014). National guidelines increasingly recommend a systematic screening of at least carbapenemase-producing Enterobacteriaceae (CPE) and glycopeptide-resistant enterococci (GRE) in patients admitted to hospitals who have been hospitalized aboard during the preceding 12 months (Lepelletier et al., 2011). We have investigated the occurrence of colonization and infection with multiple highly resistant bacteria of more than 4 different genus in 2 patients directly transferred from a foreign country.In June 2014, a 33-year-old French man (patient A) was admitted for a suicide attempt in a Vietnamese hospital where he was treated during 10 days for pneumonia with piperacillin + tazobactam before his transfer to Necker-Enfants Malades University Hospital in Paris, France. At the day of his hospitalization in France, distal protected pulmonary samples were collected, and imipenem was administered subsequently to a persistent fever. In addition, systematic screening to detect carbapenemase producers and GRE was also performed. Screening of extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae, carbapenemase producers, and GRE was done on selective media (bioMérieux, La Balme-les-Grottes, France) ChromID ESBL, ChromID Carba Smart, and VRE medium, respectively. Carbapenemase production was identified using the Carba NP test for Enterobacteriaceae (Dortet et al., 2014a) and Pseudomonas aeruginosa ( Dortet et al., 2012) and CarbAcineto NP test for Acinetobacter baumannii ( Dortet et al., 2014b). Definitive identifications of resistance determinant were done by PCR amplifications followed by sequencing. Pulmonary samples grew an OXA-23–producing A. baumannii isolate and an IMP-1–producing P. aeruginosa ( Table 1). Screening identified also that the patient was colonized with a KPC-2–producing Klebsiella pneumoniae, a CTX-M-15–producing K. pneumoniae, and a VanA-positive glycopeptide-resistant Enterococcus faecium ( Table 1)

Human Listeriosis Caused by Listeria ivanovii

Two species of Listeria are pathogenic; L. monocytogenes infects humans and animals, and L. ivanovii has been considered to infect ruminants only. We report L. ivanovii–associated gastroenteritis and bacteremia in a man. This isolate was indistinguishable from prototypic ruminant strains. L. ivanovii is thus an enteric opportunistic human pathogen

Splenic Rupture and Malignant Mediterranean Spotted Fever

International audienc

Mycobacterium abscessus and Children with Cystic Fibrosis

We prospectively studied 298 patients with cystic fibrosis (mean age 11.3 years; range 2 months to 32 years; sex ratio, 0.47) for nontuberculous mycobacteria in respiratory samples from January 1, 1996, to December 31, 1999. Mycobacterium abscessus was by far the most prevalent nontuberculous mycobacterium: 15 patients (6 male, 9 female; mean age 11.9 years; range 2.5–22 years) had at least one positive sample for this microorganism (versus 6 patients positive for M. avium complex), including 10 with >3 positive samples (versus 3 patients for M. avium complex). The M. abscessus isolates from 14 patients were typed by pulsed-field gel electrophoresis: each of the 14 patients harbored a unique strain, ruling out a common environmental reservoir or person-to-person transmission. Water samples collected in the cystic fibrosis center were negative for M. abscessus. This major mycobacterial pathogen in children and teenagers with cystic fibrosis does not appear to be acquired nosocomially