Isolation of VIM-producing multidrug-resistant Pseudomonas aeruginosa in pediatric haematology ward

The Gram-negative bacillus Pseudomonas aeruginosa is renowned for its extensive natural antibiotic resistance and opportunistic behaviour. With the exception of ertapenem, carbapenems represent the optimal pharmacological intervention for the treatment of infections caused by Pseudomonas species resistant to ceftazidime. Nevertheless, the presence of a Pseudomonas strain that produces carbapenemase renders this therapeutic approach ineffective. In this report, we describe the isolation of a multidrug-resistant VIM-producing strain of Pseudomonas aeruginosa from a patient in a paediatric haematology ward. A 13-year-old patient was admitted to the paediatric ward for the purpose of undergoing treatment for acute myeloblastic leukaemia. The patient presented with a fever of 40°C, accompanied by abdominal discomfort and diarrhoea. An abdominal ultrasound scan revealed the presence of colitis, exhibiting both inflammatory and infectious characteristics. The results of the stool analysis indicated the presence of Pseudomonas aeruginosa. Antibiotic susceptibility testing was conducted using the Gram-negative NMIC/ID 94 panel. The results of the antibiotic susceptibility testing indicated resistance to amikacin, cefepime, ceftazidime, ciprofloxacin, gentamicin, imipenem, levofloxacin, meropenem and piperacillin-tazobactam. The resistance mechanisms of carbapenem were confirmed by a positive EDTA test. The carbapenemase were detected using a chromogenic test . The isolated Pseudomonas strain was found to produce VIM. This discovery offers an opportunity to enhance the national database on the profile and resistance mechanisms of Pseudomonas aeruginosa strains. However, a molecular study of the strain is essential for precise typing of the VIM variant.