The increasing incidence of multiresistant bacterial strains is currently a serious health concern. These pathogens are often the cause of nosocomial infections with limited treatment options and high fatality rates.
A case report is presented of an uncommon detection of four different species (Citrobacter freundil, Kiebsiella pneumoniae, Escherichia coli, and Morganella morganii) producing the same type of carbapenemase, KPC-2, in a female patient during her complicated long-term hospital stay. Resistance was probably spread to other species by horizontal transmission of plasmids carrying the biaKPC-2 genes. the implementation of strict anti-epidemic measures prevented further spread of these carbapenem-resistant bacteria.