PMID- 30275958
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220331
IS  - 2053-3721 (Print)
IS  - 2053-3721 (Electronic)
IS  - 2053-3721 (Linking)
VI  - 5
IP  - 7
DP  - 2018 Jul
TI  - Extensively drug-resistant (XDR) Pseudomonas aeruginosa identified in Lima, Peru 
      co-expressing a VIM-2 metallo-beta-lactamase, OXA-1 beta-lactamase and GES-1 
      extended-spectrum beta-lactamase.
PG  - e005154
LID - 10.1099/jmmcr.0.005154 [doi]
LID - e005154
AB  - INTRODUCTION: Pseudomonas aeruginosa has the ability to acquire plasmids and 
      other mobile genetic elements that confer resistance to antibiotics. Bacterial 
      genes encoding different beta-lactamases (bla), such as metallo-beta-lactamases (MBLs) 
      and extended-spectrum beta-lactamases (ESBL), can confer resistance to multiple 
      classes of beta-lactam antibiotics. CASE PRESENTATION: An 83 year old female was 
      admitted in 2012 to the Peruvian Naval Hospital, Centro Medico Naval 'Cirujano 
      Mayor Santiago Tavara' (CEMENA), in Lima, Peru. A midstream urine sample was 
      collected and sent to the local CEMENA laboratory for routine urine culture. P. 
      aeruginosa was isolated and initial antibiotic susceptibility testing showed it 
      to be sensitive to imipenem. The clinicians started a course of meropenem, but 
      the patient did not improve. After 5 days, a second urine culture was performed 
      and a P. aeruginosa was isolated again, but this time the strain showed 
      resistance to imipenem. The treatment course was changed to fosfomycin and the 
      patient improved. Phenotypic and molecular laboratory testing to characterize the 
      antibiotic resistance were performed, demonstrating the presence of both MBL and 
      ESBL genes. CONCLUSION: To our knowledge, this is the first report of a P. 
      aeruginosa XDR clinical isolate that co-expresses an MBL (VIM-2), OXA-1 
      beta-lactamase and the ESBL (GES-1) in Peru. It is also the first report of a VIM 
      carbapenemase in Peru.
FAU - Rios, Paul
AU  - Rios P
AD  - U.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Peru.
FAU - Rocha, Claudio
AU  - Rocha C
AD  - U.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Peru.
FAU - Castro, William
AU  - Castro W
AD  - Centro Medico Naval "Cirujano Mayor Santiago Tavara (CEMENA)", Lima, Peru.
FAU - Vidal, Maria
AU  - Vidal M
AD  - Centro Medico Naval "Cirujano Mayor Santiago Tavara (CEMENA)", Lima, Peru.
FAU - Canal, Enrique
AU  - Canal E
AD  - U.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Peru.
FAU - Bernal, Manuela
AU  - Bernal M
AD  - U.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Peru.
FAU - Reynolds, Nathanael D
AU  - Reynolds ND
AD  - U.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Peru.
FAU - Tilley, Drake H Jr
AU  - Tilley DH Jr
AD  - Naval Medical Center, San Diego, USA.
FAU - Simons, Mark P
AU  - Simons MP
AD  - U.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Peru.
LA  - eng
PT  - Case Reports
DEP - 20180621
PL  - England
TA  - JMM Case Rep
JT  - JMM case reports
JID - 101639133
PMC - PMC6159545
OTO - NOTNLM
OT  - carbapenemase
OT  - metallo-beta-lactamase
COIS- The authors declare that there are no conflicts of interest.
EDAT- 2018/10/03 06:00
MHDA- 2018/10/03 06:01
PMCR- 2018/06/21
CRDT- 2018/10/03 06:00
PHST- 2018/03/24 00:00 [received]
PHST- 2018/05/23 00:00 [accepted]
PHST- 2018/10/03 06:00 [entrez]
PHST- 2018/10/03 06:00 [pubmed]
PHST- 2018/10/03 06:01 [medline]
PHST- 2018/06/21 00:00 [pmc-release]
AID - jmmcr005154 [pii]
AID - 10.1099/jmmcr.0.005154 [doi]
PST - epublish
SO  - JMM Case Rep. 2018 Jun 21;5(7):e005154. doi: 10.1099/jmmcr.0.005154. eCollection 
      2018 Jul.