Emergence of colistin resistance during treatment of recurrent pneumonia caused by carbapenemase producing Klebsiella pneumoniae

Veerle Matheeussen; Basil Britto Xavier; Ingrid Mermans; Annick De Weerdt; Christine Lammens; Herman Goossens; Hilde Jansens; Surbhi Malhotra-Kumar

doi:10.1016/j.diagmicrobio.2019.02.014

Emergence of colistin resistance during treatment of recurrent pneumonia caused by carbapenemase producing Klebsiella pneumoniae

Diagn Microbiol Infect Dis. 2019 Aug;94(4):407-409. doi: 10.1016/j.diagmicrobio.2019.02.014. Epub 2019 Feb 21.

Authors

Veerle Matheeussen¹, Basil Britto Xavier², Ingrid Mermans³, Annick De Weerdt⁴, Christine Lammens², Herman Goossens⁵, Hilde Jansens³, Surbhi Malhotra-Kumar²

Affiliations

¹ Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium. Electronic address: veerle.matheeussen@uza.be.
² Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
³ Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium.
⁴ Department of Intensive Care Medicine, Antwerp University Hospital, Edegem, Belgium.
⁵ Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.

PMID: 30890297
DOI: 10.1016/j.diagmicrobio.2019.02.014

Abstract

A 60-year-old woman received meropenem/colistin treatment for bilateral pneumonia caused by a ST15 carbapenemase producing Klebsiella pneumoniae. The patient recovered but re-infection with the same (ST15), but now colistin-resistant K. pneumoniae, occurred. The molecular mechanism of the emerged colistin resistance was identified as mgrB gene modification by insertion element (IS) IS903B.

Keywords: Carbapenemase producing Enterobactericeae; Colistin resistance; K. pneumoniae; ST15.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents / pharmacology*
Bacterial Proteins
Colistin / pharmacology*
Drug Resistance, Bacterial / genetics*
Female
Humans
Klebsiella Infections / drug therapy*
Klebsiella Infections / microbiology
Klebsiella pneumoniae / drug effects*
Klebsiella pneumoniae / enzymology
Klebsiella pneumoniae / genetics
Meropenem / therapeutic use
Microbial Sensitivity Tests
Middle Aged
Pneumonia, Bacterial / drug therapy*
Recurrence
beta-Lactamases

Substances

Anti-Bacterial Agents
Bacterial Proteins
beta-Lactamases
carbapenemase
Meropenem
Colistin