A pediatric patient with B-cell acute lymphoblastic leukemia (B-ALL), undergoing chemotherapy, presented with a urinary tract infection. Urine culture identified Enterococcus faecium, which exhibited resistance to both vancomycin and linezolid. This dual resistance was confirmed by phenotypic susceptibility testing and whole-genome sequencing, revealing the presence of vanA and optrA genes. The patient was successfully treated with daptomycin. This case highlights the emergence of extensively drug-resistant Enterococcus faecium in immunocompromised pediatric populations, emphasizing the critical need for vigilant surveillance and appropriate antimicrobial stewardship.
Key note: The emergence of linezolid-resistant and vancomycin-resistant Enterococcus faecium in immunocompromised children necessitates careful monitoring and alternative treatment strategies.