Fatal Carbapenem Resistance Development in Pseudomonas Aeruginosa Under Meropenem Monotherapy, Caused by Mutations in the OprD Outer Membrane Porin

Pediatr Infect Dis J. 2019 Apr;38(4):398-399. doi: 10.1097/INF.0000000000002244.

Abstract

A 13-year old neutropenic boy succumbed to bacteremia and sepsis with a Pseudomonas aeruginosa strain that rapidly developed resistance to carbapenems during meropenem monotherapy. Whole genome sequencing of the susceptible and resistant blood culture isolates revealed the meropenem-resistant phenotype to be caused by truncation of the OprD gene, which added to a preexisting inactivated mexR gene.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Blood Culture
  • Fatal Outcome
  • Humans
  • Male
  • Meropenem / administration & dosage*
  • Mutation*
  • Porins / genetics*
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / genetics
  • Sequence Deletion
  • Whole Genome Sequencing
  • beta-Lactam Resistance*

Substances

  • Anti-Bacterial Agents
  • Porins
  • OprD protein, Pseudomonas aeruginosa
  • Meropenem