Isolation of Hafnia paralvei co-harbouring bla(NDM-1) and bla(VIM-1) in a woman who underwent allogeneic hematopoietic stem cell transplantation

Metallo-β-lactamases (MBL) are a threat to public health, since they dramatically limit the use of β-lactams. We report the isolation of a multidrug-resistant Hafnia paralvei strain from urine and a rectal swab of a female patient after allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome. Antimicrobial susceptibility testing yielded resistance to trimethoprim/sulfamethoxazole, colistin, fosfomycin and all β-lactams, except cefiderocol. Whole genome sequencing revealed the presence of plasmid-encoded NDM-1 and VIM-1 carbapenemases. This finding highlights the importance of epidemiological surveillance and new therapeutic options for MBL.