ritical revision of article; Approval of article.

Tahar Delassi[:]{.ul} Data collection.

Mustapha Elhattaoui[:]{.ul} Critical revision of article; Approval of article.

Nadir Saoudi[:]{.ul} Critical revision of article; Approval of article.

Declaration of competing interest
=================================

None.

Peer review under responsibility of Indian Heart Rhythm Society.

[^1]: APT: antiplatelet therapy; ATT: antithrombotic therapy; BiV: biventricular; DOAC: direct oral anticoagulant; LWMH: low weight molecular heparin; PM: pacemaker; VKA: vitamin K antagonist; 3C: three chambers.

[^2]: GW: guidewires; N/A: non-available; PM: pacemakers; SVC: superior vena cava.


Introduction
============

Here, we report that one suspected dead case and two confirmed, rapid onset and fatal infections caused by a *Klebsiella pneumoniae* ST86 strain occurred in a three-bed surgery ward of a university hospital with 1,800 beds and 40,000 annual admissions in Shanghai, China in 2013 (See **Figure [1](#F1){ref-type="fig"}**).

![**The clinical and epidemiological characteristics of the three cases in this study**.](fmicb-06-00721-g001){#F1}

The first suspected patient, a 64-year-old male, after resuscitation from acute recurrent myocardial infarction, was sent to the surgery ward at 3 PM, on May 31th. In addition, the patient has the following diseases: coronary atherosclerotic heart disease, cerebral infarction, hypertension, type 2 diabete, and hyperlipoidemia. Since June 1st, the patient was initially treated empirically with moxifloxacin (400 mg daily) and gradually improved. At that time, the WBC count was 9.10 × 10^9^/L with 64.3% granulocytes and 20.7% lymphocytes. However, on June 4th, his WBC count increased to 9.59 × 10^9^/L with unusual 82.0% granulocytes and 8.1% lymphocytes, accompanied by a high temperature, breathing difficulty, and brick red foamy blood sputum, and followed by respiratory distress syndrome. Immediately, the patient was transferred into an intensive care unit (ICU) and died at 4 AM, on 