An Immunocompromised Child with Bloodstream Infection Caused by Two Escherichia coli Strains, One Harboring NDM-5 and the Other Harboring OXA-48-Like Carbapenemase

M Earth Hasassri; Thomas G Boyce; Andrew P Norgan; Scott A Cunningham; Patricio R Jeraldo; Scott J Weissman; Robin Patel; Ritu Banerjee; Jason M Pogue; Keith S Kaye

doi:10.1128/AAC.03118-15

An Immunocompromised Child with Bloodstream Infection Caused by Two Escherichia coli Strains, One Harboring NDM-5 and the Other Harboring OXA-48-Like Carbapenemase

Antimicrob Agents Chemother. 2016 May 23;60(6):3270-5. doi: 10.1128/AAC.03118-15. Print 2016 Jun.

Authors

Affiliations

¹ Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
² Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³ Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
⁴ Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Seattle Children's Research Institute, Seattle, Washington, USA.
⁶ Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁷ Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA [email protected] [email protected].
⁸ Wayne State University and Detroit Medical Center, Detroit, Michigan, USA.
⁹ Wayne State University and Detroit Medical Center, Detroit, Michigan, USA [email protected] [email protected].

Abstract

We describe a 16-year-old neutropenic patient from the Middle East with bloodstream infection caused by two carbapenemase-producing Escherichia coli isolates that we characterized by whole-genome sequencing. While one displayed meropenem resistance and was blaNDM positive, the other demonstrated meropenem susceptibility yet harbored blaOXA181 (which encodes a blaOXA48-like enzyme). This report highlights the challenge of laboratory detection of blaOXA48-like enzymes and the clinical implications of genotypic resistance detection in carbapenemase-producing Enterobacteriaceae.

MeSH terms

Adolescent
Amikacin / pharmacology
Anti-Bacterial Agents / pharmacology*
Aztreonam / pharmacology
Bacterial Proteins / genetics
Bacterial Proteins / metabolism*
Ciprofloxacin / pharmacology
Ertapenem
Escherichia coli / drug effects
Escherichia coli / enzymology*
Escherichia coli / genetics
Female
Gentamicins / pharmacology
Humans
Immunocompromised Host
Meropenem
Penicillanic Acid / analogs & derivatives
Penicillanic Acid / pharmacology
Piperacillin / pharmacology
Piperacillin, Tazobactam Drug Combination
Tazobactam
Thienamycins / pharmacology
Tobramycin / pharmacology
beta-Lactamases / genetics
beta-Lactamases / metabolism*
beta-Lactams / pharmacology

Substances

Anti-Bacterial Agents
Bacterial Proteins
Gentamicins
Thienamycins
beta-Lactams
Piperacillin, Tazobactam Drug Combination
Ciprofloxacin
Amikacin
Penicillanic Acid
beta-Lactamases
carbapenemase
Meropenem
Aztreonam
Ertapenem
Tazobactam
Tobramycin
Piperacillin

Grants and funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.