Isolation of multiple carbapenemase-producing Gram-negative bacilli from a patient recently hospitalized in Nigeria

A 29-year-old female transferred to a tertiary care hospital in Winnipeg, Canada, after a prolonged period of hospitalization in Nigeria was found to be colonized with a VIM-2-producing Pseudomonas aeruginosa, a NDM-1-producing Klebsiella pneumoniae, and an OXA-181-producing Escherichia coli. Detection of carbapenemase-producing organisms from a rectal swab was accomplished by screening with chromogenic media, followed by confirmation with the Rapid CARB Screen kit (Rosco Diagnostica, Taastrup, Denmark). This case illustrates the need for clinical microbiology laboratories to have a protocol in place to screen patients for carbapenemase producers, even in countries where these organisms are rarely encountered.