title: Prolonged bacteraemia caused by VIM-1 metallo-beta-lactamase-producing Proteus mirabilis: first report from Italy.
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.
authors.affiliation: Dipartimento di Medicina Clinica, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Falcone
authors.forename: M
authors.initials: M
authors.lastname: Perilli
authors.forename: M L
authors.initials: ML
authors.lastname: Mezzatesta
authors.forename: C
authors.initials: C
authors.lastname: Mancini
authors.forename: G
authors.initials: G
authors.lastname: Amicosante
authors.forename: S
authors.initials: S
authors.lastname: Stefani
authors.forename: M
authors.initials: M
authors.lastname: Venditti
mesh_terms: D000368:Aged; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D015780:Carbapenems / Q000494:pharmacology; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use; D002876:Chromosomes, Bacterial; D004269:DNA, Bacterial / Q000235:genetics; D006801:Humans; D032023:Integrons; D007558:Italy; D008297:Male; D000077731:Meropenem; D010957:Plasmids; D011512:Proteus Infections / Q000188:drug therapy / Q000382:microbiology*; D011513:Proteus mirabilis / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology*; D013845:Thienamycins / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D004269:DNA, Bacterial; D013845:Thienamycins; D000077723:Cefepime; D000583:Amikacin; C417264:VIM-1 metallo-beta-lactamase; D001618:beta-Lactamases; D000077731:Meropenem