Content area
Abstract
We report the emergence of colistin resistance in Klebsiella pneumoniae carbapenemase (KPC)–producing Klebsiella pneumoniae after 8 days of colistin-based therapy, resulting in relapse of bloodstream infection and death. Disruption of the mgrB gene by insertion of a mobile genetic element was found to be the mechanism, which was replicated in vitro after exposure to subinhibitory concentrations of colistin and meropenem.
Details
Title
Emergence of Resistance to Colistin During the Treatment of Bloodstream Infection Caused by Klebsiella pneumoniae Carbapenemase–Producing Klebsiella pneumoniae
Author
Kanwar, Anubhav 1 ; Marshall, Steven H 2 ; Perez, Federico 3 ; Myreen Tomas 4 ; Jacobs, Michael R 5 ; Hujer, Andrea M 6 ; Domitrovic, T Nicholas 6 ; Rudin, Susan D 6 ; Rojas, Laura J 7 ; Kreiswirth, Barry N 8 ; Chen, Liang 8 ; Quinones-Mateu, Miguel 9 ; David van Duin 10 ; Bonomo, Robert A 11
1 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
2 Research Service
3 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Research Service; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
4 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
5 Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
6 Research Service; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
7 Research Service; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio
8 Public Health Research Institute Center New Jersey Medical School - Rutgers, The State University of New Jersey, Newark, New Jersey
9 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio
10 Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina
11 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Research Service; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio
1 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
2 Research Service
3 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Research Service; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
4 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
5 Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
6 Research Service; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
7 Research Service; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio
8 Public Health Research Institute Center New Jersey Medical School - Rutgers, The State University of New Jersey, Newark, New Jersey
9 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio
10 Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina
11 Division of Infectious Diseases and HIV Medicine, Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Research Service; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio
Publication year
2018
Publication date
Apr 2018
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3170969198
Copyright
Published by Oxford University Press on behalf of Infectious Diseases Society of America 2018.