Extensively drug-resistant - a case series of urinary tract infections in immunocompromised patients.

Purpose: We report an outbreak of urinary tract infections (UTIs) caused by , which occurred in the largest clinical hospital in western Romania.

Patients And Methods: From June to August 2017, four strains of were isolated from the urine samples of patients hospitalized in the urology, diabetes, and surgery departments. Hospital records of all patients whose urine cultures were positive for were reviewed retrospectively. We also reviewed the cases reported in the literature.

Results: All UTIs, except one, were hospital-acquired infections. All patients with UTIs were immunocompromised. Three patients underwent urinary catheterization with a Foley's catheter upon admission in the emergency department and one presented for replacement of ureterostomy tubes. All isolates were resistant to almost all the tested antibiotics. Two patients were successfully treated with tigecycline and one was receiving antimicrobial treatment for another infection at the time of isolation of the microorganism.

Conclusion: Although is an uncommon pathogen, clinicians should be aware of its ability to cause UTI outbreaks, especially in the immunocompromised population. Due to its multi-drug resistance, it is important to rapidly identify spp. in order to choose the best treatment regimen.