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During the course of an outbreak due to Verona integron-encoded Metallo- β -lactamase (VIM)-producing  Klebsiella pneumonia  (KP) in the neonatal intensive care unit (NICU) of Maggiore Hospital in Bologna (Italy), an 8-day-old extremely low birth weight (ELBW) infant developed a severe ventilator-associated pneumonia (VAP) with concomitant bacteraemia. Although the microorganism was susceptible only to colistin and tigecycline, the patient was successfully treated with a combination of antibiotics including high-dosage, prolonged infusion of meropenem (MEM) and intravenous plus aerosolised gentamicin (GEN). This report highlights that, even when the microorganism is considered non-susceptible to MEM and GEN, the combination of these two agents could have a significant survival benefit.

Verona integron-encoded metallo- β -lactamase-producing Klebsiella pneumoniae sepsis in an extremely premature infant