Outbreak of an uncommon rifampin-resistant blaNDM-1 citrobacter amalonaticus strain in a digestive rehabilitation center: The putative role of rifaximin

Abstract

We describe a sudden 2-week outbreak due to a blaNDM-1 Citrobacter amalonaticus strain in a 22-bed digestive rehabilitation center. Three of the 5 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 adenosine diphosphate-ribosyl transferase.