Balanoposthitis caused by Pseudomonas aeruginosa co-producing metallo-β-lactamase and 16S rRNA methylase in children with hematological malignancies

摘要: Balanoposthitis is defined as the inflammation of glans penis and its foreskin. In presence other underlying medical conditions, this localized infection may spread systemically, serving a source fever bacteremia in neutropenic males. Two rare cases balanoposthitis caused by clonally related Pseudomonas aeruginosa isolate co-producing SPM-1 metallo-beta-lactamase novel 16S rRNA methylase RmtD are described. Four multidrug-resistant (MDR) P. isolates were successively recovered from glans/foreskin swabs urine cultures two uncircumcised pediatric patients, one with Burkitt's non-Hodgkin's lymphoma acute lymphoblastic leukemia. Clinically, preputial colonization MDR evolved to severe lesions fever. Combination therapy ciprofloxacin and/or aztreonam (systemic) plus polymyxin B (topical) was effective once reversion condition achieved. Although remains an unusual cause balanoposthitis, these should alert physician potential pathogenicity bacterium. Furthermore, co-production has impact on empirical management complicated infections aeruginosa.