A case of New Delhi metallo-β-lactamase 1 (NDM-1)-producing Klebsiella pneumoniae with putative secondary transmission from the Balkan region in the Netherlands

摘要

Patient B, a 73-year-old female with no travel history outside the Netherlands, was admitted with exacerbation of pulmonary symptoms to the department of pulmonary disease (DPD) in the same hospital as the first patient between 10 October and 7 November 2008. At the end of October, ESBL-producing K. pneu-moniae was cultured from a urine specimen. The patient was treated with oral amoxicillin-clavulanate in addition to removal of the urinary catheter and was discharged from the hospital in good condition. A urinary culture obtained during readmission to the DPD on 25 June 2010 with pulmonary symptoms and urinary tract infection yielded only Escherichia coli. For the urinary tract infection, the patient was treated with ciprofloxacin, to which the E. coli strain was susceptible. The patient died on 18 July 2010.