This weeks MMWR has a report from Len Mermel's group of a patient initially hospitalized in Viet Nam. Upon readmission earlier this year to a hospital in Rhode Island she had a Klebsiella pneumoniae containing NDM-1 recovered from a urine specimen. The isolate was only susceptible to tigecycline, and the polymyxins.
Extensive surveillance testing was completed and one patient admitted to the same hematology-oncology unit grew an NDM-1 containing K. pneumoniae isolate from a rectal surveillance swab. This isolate was indistinguishable from the index patient's isolates by PFGE, confirming patient-to-patient transmission.