Invasive Trichosporonosis in a Critically Ill ICU Patient: Case Report
Sir, In the context of increased isolation globally of carbapenemresistant Enterobacteriaceae (KPC-1 to KPC-10), the emergence of the New-Delhi metallo-beta-lactamase-1 (NDM-1) strain is not surprising. We however question its proposed Asian origin in the recent “Lancet Infectious Diseases” publication. In the Lancet study, the fact that there were only 59% of patients with history of travel from, or surgery in, Asia; and their observation “we could not prove statistically significant strain relatedness between the Indian and UK isolates” suggest that acquisition of infection and resistance could have occurred within the UK. More rigid methods — akin to eBURST analysis, which predicted the ancestral clonal complex for Methicillin-resistant Staphylococcus aureus (MRSA) — need to be used to attribute causality.