Fatal respiratory infection due to ST308 VIM-1-producing Pseudomonas aeruginosa in a lung transplant recipient: case report and review of the literature

BMC Infectious Diseases

IFALT working group¹  D. Girelli²  L. Cariani²  G. Grasselli³  A. P. Cantù⁴  A. M. Peri⁵  A. Gori⁵  M. Carugati⁵  A. Bandera⁵  F. Blasi⁶  M. Pappalettera⁶  A. Gramegna⁶  M. Arghittu⁷  M. Brilli⁸  C. Bandi⁸  D. Di Carlo⁹  F. Comandatore⁹  A. Piazza⁹ 

[1] ;Cystic Fibrosis Microbiology Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico;Department of Pathophysiology and Transplantation, Università degli Studi di Milano;Direzione Medica di Presidio, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico;Division of Infectious Diseases, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico;Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico;Laboratory of Microbiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico;Romeo and Enrica Invernizzi Pediatric CRC, Department of Biosciences, University of Milan;Romeo and Enrica Invernizzi Pediatric Research Center, Department of Biomedical and Clinical Sciences, University of Milan;

关键词: Cystic fibrosis;    Lung transplant;    Pseudomonas aeruginosa;    Metallo-β-lactamases;    Case report;   

DOI  :  10.1186/s12879-020-05338-3

来源: DOAJ

【 摘 要 】

Abstract Background Data regarding the prevalence of metallo-β-lactamases (MBLs) among Pseudomonas aeruginosa isolates in cystic fibrosis patients are scarce. Furthermore, there is limited knowledge on the effect of MBL production on patient outcomes. Here we describe a fatal respiratory infection due to P. aeruginosa producing VIM-type MBLs in a lung transplant recipient and the results of the subsequent epidemiological investigation. Case presentation P. aeruginosa isolates collected in the index patient and among patients temporally or spatially linked with the index patient were analyzed in terms of antibiotic susceptibility profile and MBL production. Whole-genome sequencing and phylogenetic reconstruction were also performed for all P. aeruginosa isolates producing VIM-type MBLs. A VIM-producing P. aeruginosa strain was identified in a lung biopsy of a lung transplant recipient with cystic fibrosis. The strain was VIM-1-producer and belonged to the ST308. Despite aggressive treatment, the transplant patient succumbed to the pulmonary infection due to the ST308 strain. A VIM-producing P. aeruginosa strain was also collected from the respiratory samples of a different cystic fibrosis patient attending the same cystic fibrosis center. This isolate harbored the blaVIM-2 gene and belonged to the clone ST175. This patient did not experience an adverse outcome. Conclusions This is the first description of a fatal infection due to P. aeruginosa producing VIM-type MBLs in a lung transplant recipient. The circulation of P. aeruginosa isolates harboring MBLs pose a substantial risk to the cystic fibrosis population due to the limited therapeutic options available and their spreading potential.

【 授权许可】

Unknown