Abstract
Persistent bacteraemia arising from a case of post-operative mediastinitis as a result of a Proteus mirabilis isolate, possessing two class 1 integrons carrying bla(VIM-1) and aadA2 gene cassettes located on chromosomal and plasmidic DNA, respectively, is reported. Despite the in vitro susceptibility to carbapenems, meropenem therapy failed, whereas the patient responded to treatment with cefepime plus amikacin. To our knowledge, this is the first report of metallo-beta-lactamase production in a clinical isolate of P. mirabilis in Italy.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Amikacin / therapeutic use
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use
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Bacteremia / drug therapy
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Bacteremia / microbiology*
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Carbapenems / pharmacology
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Cefepime
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Cephalosporins / therapeutic use
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Chromosomes, Bacterial
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DNA, Bacterial / genetics
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Humans
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Integrons
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Italy
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Male
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Meropenem
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Plasmids
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Proteus Infections / drug therapy
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Proteus Infections / microbiology*
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Proteus mirabilis / enzymology*
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Proteus mirabilis / genetics
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Proteus mirabilis / isolation & purification*
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Surgical Wound Infection / drug therapy
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Surgical Wound Infection / microbiology*
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Thienamycins / therapeutic use
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Treatment Failure
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Treatment Outcome
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beta-Lactamases / biosynthesis
Substances
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Anti-Bacterial Agents
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Carbapenems
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Cephalosporins
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DNA, Bacterial
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Thienamycins
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Cefepime
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Amikacin
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VIM-1 metallo-beta-lactamase
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beta-Lactamases
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Meropenem