title: Transfer between an Algerian and a French hospital of four multi-drug resistant bacterial strains together via a single patient.
abstract: A 5 years-old girl, seriously burnt with fire, was first hospitalized during four days in an hospital at Alger, and then transferred to our hospital at Paris. Admitted in our intensive care burns unit, she was third degree burnt on 78% of total body surface area, already treated with imipenem and vancomycin at her arrival. Clinical aggravation was rapidly observed and death occurred within 24 hours. Cultures of blood and multiple wound swabs yielded 3 multi-drug resistant bacterial strains: Acinetobacter baumannii with carbapenemase OXA-23, Pseudomonas aeruginosa serotype O11 with metallo-ß-lactamase VIM-4 and Klebsiella pneumoniae with CTX-M-15 extended-spectrum ß-lactamase. Culture of a rectal swab showed colonization by Enterococcus faecium with vanA glycopeptides resistance. Patients colonized with one or two multi-drug-resistant strains were not rare in our burns unit, especially those transferred from Algeria, but this case of a single patient harboring four multi-drug-resistant strains is exceptional.
authors.affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Trousseau. Départment de Bactériologie, Faculté de Médecine, Université Pierre et Marie Curie-Paris 6 Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Moissenet
authors.affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Trousseau. Service de Réanimation Brûlés, Faculté de Médecine, Université Pierre et Marie Curie-Paris 6 Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Richard
authors.affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Trousseau. Service de Réanimation Brûlés, Faculté de Médecine, Université Pierre et Marie Curie-Paris 6 Paris, France.
authors.forename: Maria
authors.initials: M
authors.lastname: Granados
authors.affiliation: Hôpital d'Instruction des Armées Bégin, Service de Biologie Médicale Saint Mandé, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Mérens
authors.affiliation: Centre National de Référence de la Résistance aux Antibiotiques, Expertise Pseudomonas Aeruginosa et Acinetobacter Baumannii, Laboratoire de Bactériologie, Hôpital Jean Minjoz, CHRU 25030 Besançon, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Fournier
authors.affiliation: Centre National de Référence de la Résistance Aux Antibiotiques, Expertise Entérocoques, Laboratoire de Microbiologie, CHU 14033 Caen, France.
authors.forename: Marguerite
authors.initials: M
authors.lastname: Fines-Guyon
authors.affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Trousseau. Départment de Bactériologie, Faculté de Médecine, Université Pierre et Marie Curie-Paris 6 Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Arlet
authors.affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Trousseau. Départment de Bactériologie, Faculté de Médecine, Université Pierre et Marie Curie-Paris 6 Paris, France.
authors.forename: Hoang
authors.initials: H
authors.lastname: Vu-Thien
keywords: Third degree burns; carbapenemase; extended-spectrum ß-lactamase; four multi-drug-resistant strains; glycopeptides resistance; metallo-ß-lactamase