Bloodstream infections by multidrug-resistant Pluralibacter gergoviae in premature neonates in Central-West Brazil: Report of two cases.

Two cases of bloodstream infections caused by multidrug-resistant Pluralibacter gergoviae (KPC+) in premature neonates hospitalized in a neonatal intensive care unit in Brazil are presented. Strains from these cases were confirmed by 16S rRNA sequencing and matrix assisted laser desorption ionization-time of flight/mass spectrometry using MALDI Biotyper®, with further typing using Fourier-transform infrared spectroscopy using IR Biotyper®. The cases were unrelated, as evidenced by clustering analysis. Both neonates displayed risk factors including prolonged hospitalization, invasive device use, and prior antibiotic treatments. Case 1 exhibited clinical recovery following treatment with polymyxin B and amikacin, whereas Case 2 resulted in death despite multiple antibiotic regimens. Isolated strains showed resistance to carbapenems and harbored the blaKPC, highlighting the critical need for targeted diagnostics and stringent infection control in neonatal intensive care units. These findings underscore the significance of monitoring emerging pathogens like P. gergoviae, which possess high multidrug resistance and limited therapeutic options.