title: An Immunocompromised Child with Bloodstream Infection Caused by Two Escherichia coli Strains, One Harboring NDM-5 and the Other Harboring OXA-48-Like Carbapenemase.
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.
authors.affiliation: Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: M Earth
authors.identifier: 0000-0003-1797-1826
authors.initials: ME
authors.lastname: Hasassri
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Boyce
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Norgan
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Cunningham
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Patricio R
authors.identifier: 0000-0003-0282-4217
authors.initials: PR
authors.lastname: Jeraldo
authors.affiliation: Seattle Children's Research Institute, Seattle, Washington, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Weissman
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Patel
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA banerjee.ritu@mayo.edu Kkaye@dmc.org.
authors.forename: Ritu
authors.initials: R
authors.lastname: Banerjee
authors.affiliation: Wayne State University and Detroit Medical Center, Detroit, Michigan, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Pogue
authors.affiliation: Wayne State University and Detroit Medical Center, Detroit, Michigan, USA banerjee.ritu@mayo.edu Kkaye@dmc.org.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
mesh_terms: D000293:Adolescent; D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001398:Aztreonam / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D002939:Ciprofloxacin / Q000494:pharmacology; D000077727:Ertapenem; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D005260:Female; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D016867:Immunocompromised Host; D000077731:Meropenem; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000494:pharmacology; D010878:Piperacillin / Q000494:pharmacology; D000077725:Piperacillin, Tazobactam Drug Combination; D000078142:Tazobactam; D013845:Thienamycins / Q000494:pharmacology; D014031:Tobramycin / Q000494:pharmacology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D005839:Gentamicins; D013845:Thienamycins; D047090:beta-Lactams; D000077725:Piperacillin, Tazobactam Drug Combination; D002939:Ciprofloxacin; D000583:Amikacin; D010397:Penicillanic Acid; D001618:beta-Lactamases; C063912:carbapenemase; D000077731:Meropenem; D001398:Aztreonam; D000077727:Ertapenem; D000078142:Tazobactam; D014031:Tobramycin; D010878:Piperacillin