Outbreak of an uncommon carbapenemase producing Enterobacteriaceae in a digestive rehabilitation center: putative role of Rifaximin. Outbreak of an uncommon carbapenemase producing Enterobacteriaceae

We describe a sudden two-weeks outbreak due to a bla NDM-1 Citrobacter amaloniticus in a 22-beds digestive rehabilitation center. Three out of the five colonized patients received long-term rifaximin treatment to prevent hepatic encephalopathy. The strains were genotypically identical, phenotypically resistant to rifampin and harbored arr-3, a rifampin ADP-ribosyl transferase.