Extremely Drug-Resistant Citrobacter freundii Isolate Producing NDM-1 and Other Carbapenemases Identified in a Patient Returning from India

Antimicrobial Agents and Chemotherapy
2011.0

Abstract

We report here the case of an 18-year-old French female returning from India with a Citrobacter freundii isolate (STE) highly resistant to all β-lactams (including carbapenems) and other antibiotics. Genetic analysis identified the blaNDM-1, blaVIM-4, and blaOXA-181 carbapenemase genes, as well as other resistance genes (blaCTX-M-15, armA). Plasmid analysis revealed five plasmids, with blaNDM-1 on a 65-kb plasmid. This is the first importation of an Indian NDM-1-producing isolate in France, validating nationwide screening for multidrug-resistant bacteria in patients transferred from foreign hospitals and highlighting that unrelated carbapenemase genes and 16S RNA methylases may co-spread with blaNDM-1, further reducing therapeutic options.

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