title: ESBL E coli and P. aeruginosa Resistance to Ceftolozane-Tazobactam in a Patient with a Liver Abscess. The Search for an Omnipotent Antibiotic Goes On!
abstract: Multi drug resistant (MDR) Pseudomonas aeruginosa and Extended- Spectrum-lactamase (ESBL) Enterobacteriaceae are becoming an increasing difficult clinical problem. Immediate resistance to some of the new antimicrobials such as ceftolozane/tazobactam is unusual and is due to a variety of mechanisms such as hyper-production of inactivating enzymes and gene mutation. In addition, previous antimicrobial administration is a well-recognized risk factor to develop resistance. We present a patient with a liver abscess where the organism was resistant to ceftolozane/tazobactam resulting in a poor clinical outcome.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Texas Tech University, Texas 79902, United States.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Teleb
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Texas Tech University, Texas 79902, United States.
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto-Ruiz
authors.affiliation: Department of Clinical Laboratory Sciencem, The University of Texas at El Paso, Lubbock, TX, United States.
authors.forename: Delfina C
authors.initials: DC
authors.lastname: Dominguez
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Texas Tech University, Texas 79902, United States.
authors.forename: Suresh
authors.initials: S
authors.lastname: Antony
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002511:Cephalosporins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000188:drug therapy / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D000078142:Tazobactam; D001618:beta-Lactamases / Q000096:biosynthesis / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; C000594038:ceftolozane, tazobactam drug combination; D010397:Penicillanic Acid; D001618:beta-Lactamases; D000078142:Tazobactam
keywords: Ceftolozane/Tazobactam; ESBL; gram negative bacteria; mutation; pseudomonas; resistance