{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:01:00Z","timestamp":1786122060479,"version":"build-2736575974"},"reference-count":17,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015550","name":"PAN-HUB 2021 project","doi-asserted-by":"publisher","award":["T4-AN-07"],"award-info":[{"award-number":["T4-AN-07"]}],"id":[{"id":"10.13039\/501100015550","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Neurorehabilitation units (NRUs) are long-term care settings associated with multiple risk factors for carriage and infection by multidrug-resistant organisms (MDROs), including prolonged hospitalization, the use of invasive medical devices, high antibiotic exposure, and multiple comorbidities. We report the case of a patient admitted to an NRU for rehabilitation after cerebral hemorrhage who developed complex co-colonization by several MDROs, including Pseudomonas aeruginosa producing either FIM or VIM metallo-\u03b2-lactamases, Acinetobacter baumannii producing OXA-23 serine-carbapenemase, Klebsiella pneumoniae producing either KPC or OXA-48 serine-carbapenemases or both, Proteus mirabilis producing VEB extended-spectrum \u03b2-lactamase, and vancomycin-resistant Enterococcus faecium of the VanA type. During the 22-month hospitalization, the patient experienced several infection episodes, some of which were apparently related with colonizing MDROs. This case highlights that co-colonization by multiple MDROs may occur in patients admitted to NRUs in endemic settings, and emphasizes the importance of implementing targeted infection prevention and control strategies in these healthcare environments.<\/jats:p>","DOI":"10.3390\/microorganisms14081731","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:01:36Z","timestamp":1786089696000},"page":"1731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Co-Colonization by Multiple Multidrug-Resistant Organisms in a Long-Term Neurorehabilitation Setting: A Case Report"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7171-5060","authenticated-orcid":false,"given":"Camilla","family":"Grifoni","sequence":"first","affiliation":[{"name":"Severe Brain Injuries Unit, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"},{"name":"NARR Joint Laboratory, University of Florence, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bonaiuto","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicla","family":"Giovacchini","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-4037","authenticated-orcid":false,"given":"Marco","family":"Coppi","sequence":"additional","affiliation":[{"name":"NARR Joint Laboratory, University of Florence, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0295-6877","authenticated-orcid":false,"given":"Alberto","family":"Antonelli","sequence":"additional","affiliation":[{"name":"NARR Joint Laboratory, University of Florence, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Pollini","sequence":"additional","affiliation":[{"name":"NARR Joint Laboratory, University of Florence, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Pupillo","sequence":"additional","affiliation":[{"name":"Medical Direction, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9386-0434","authenticated-orcid":false,"given":"Gian Maria","family":"Rossolini","sequence":"additional","affiliation":[{"name":"NARR Joint Laboratory, University of Florence, IRCCS Don Gnocchi Foundation, 50143 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Villodres, \u00c1., Mart\u00edn-Gandul, C., Pe\u00f1alva, G., Guisado-Gil, A.B., Crespo-Rivas, J.C., Pach\u00f3n-Ib\u00e1\u00f1ez, M.E., Lepe, J.A., and Cisneros, J.M. 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