Fatal respiratory infection due to ST308 VIM-1-producing Pseudomonas aeruginosa in a lung transplant recipient: case report and review of the literature.
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.
Type
Journal articleSubject
IFALT working groupPermalink
https://hdl.handle.net/10161/21408Published Version (Please cite this version)
10.1186/s12879-020-05338-3Publication Info
Carugati, M; Piazza, A; Peri, AM; Cariani, L; Brilli, M; Girelli, D; ... IFALT working
group (2020). 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, 20(1). pp. 635. 10.1186/s12879-020-05338-3. Retrieved from https://hdl.handle.net/10161/21408.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Manuela Carugati
Associate Professor of Medicine

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