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. 2019 May 6;9:6949. doi: 10.1038/s41598-019-42824-4

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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The time line of the patient, who initially presented with acute severe necrotizing pancreatitis on day 0 (admission). Over time, various microorganisms were isolated from clinical samples: E. coli on day 21 from fine needle aspirate (sensitive to all β-lactam antibiotics), Serratia marcescens (pip/tazo resistant) and Enterococcus faecium (amoxicillin resistant, vancomycin susceptible) on day 35 from transgastric drainage fluid. Serratia marcescens was also isolated from blood cultures on day 37. From day 65 on, a vancomycin resistant E. faecium was also isolated from rectal swabs. Earlier rectal swabs did not produce vancomycin resistant enterococci. Abbreviations: Amoxi-Clav (Amoxicillin-clavulanic acid), Pip/Tazo (piperacillin-tazobactam).