Multidrug-resistant Pseudomonas aeruginosa isolate co-expressing extended-spectrum -lactamase PER-1 and metallo- -lactamase VIM-2 from Turkey

Sir, The emergence of acquired metallo-β-lactamases (MBLs) in Gram-negative bacteria, especially in Pseudomonas spp., gives rise to significant therapeutic challenges for treating nosocomial infections due to multidrug-resistant pathogens.1 The first reports of transferable MBLs reported IMP types at the end of the 1980s in Japan. The most common MBL identified worldwide is now VIM-2,1,2 but only VIM-5 and IMP-1 MBLs have been identified in Turkey to date.1,3 Although clavulanic acid-inhibited extended-spectrum β-lactamases (ESBLs) are rarely reported from Pseudomonas aeruginosa, ESBL PER-1-positive P. aeruginosa are widespread in Turkey.4 In this study, we report a multidrug-resistant P. aeruginosa isolate, which was recovered from a 2-year-old child suffering from pneumonia in an underlying context of cystic fibrosis. The strain was isolated from several endotracheal aspirates and blood cultures and was identified with the API32GN system (bioMérieux, Marcy l'Étoile, France). Disc diffusion and broth microdilution methods were used to determine antibiotic susceptibility, and results were interpreted according to the CLSI criteria.