Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug 26;20(1):635.
doi: 10.1186/s12879-020-05338-3.

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

M Carugati  1   2 , A Piazza  3 , A M Peri  4 , L Cariani  5 , M Brilli  6 , D Girelli  5 , D Di Carlo  3 , A Gramegna  7   8 , M Pappalettera  7 , F Comandatore  3 , G Grasselli  8   9 , A P Cantù  10 , M Arghittu  11 , A Gori  4   8   12 , C Bandi  6 , F Blasi  7   8 , A Bandera  4   8 ; IFALT working group
Affiliations
Review

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

M Carugati et al. BMC Infect Dis. .

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.

Keywords: Case report; Cystic fibrosis; Lung transplant; Metallo-β-lactamases; Pseudomonas aeruginosa.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Heatmap of the resistance gene presence/absence of the Pseudomonas aeruginosa isolates SK76, SK77, and SK78. The antimicrobial gene family is shown on the first column on the left
Fig. 2
Fig. 2
Maximum likelihood phylogenetic tree including the three Pseudomonas aeruginosa isolates of the study (SK76, SK77 and SK78) and background strains retrieved from the PATRIC database
See this image and copyright information in PMC

References

    1. Poole K. Pseudomonas aeruginosa: resistance to the max. Front Microbiol. 2011;2:65. doi: 10.3389/fmicb.2011.00065. - DOI - PMC - PubMed
    1. Breidenstein EBM, de la Fuente C, Hancock R. Pseudomonas aeruginosa: all roads lead to resistance. Trends Microbiol. 2011;19:419–426. doi: 10.1016/j.tim.2011.04.005. - DOI - PubMed
    1. European Centre for Disease Prevention and Control . Surveillance of antimicrobial resistance in Europe 2018. Stockholm: ECDC; 2019.
    1. Mustafa MH, Chalhoub H, Denis O, Deplano A, Vergison A, Rodriguez-Villalobos H, et al. Antimicrobial susceptibility of Pseudomonas aeruginosa isolated from cystic fibrosis patients in northern Europe. Antimicrob Agents Chemother. 2016;60:6735–6741. doi: 10.1128/AAC.01046-16. - DOI - PMC - PubMed
    1. Horcajada JP, Montero M, Oliver A, Sorlí L, Luque S, Gómez-Zorrilla S, et al. Epidemiology and treatment of multidrug-resistant and extensively drug-resistant Pseudomonas aeruginosa infections. Clin Microbiol Rev. 2019;32:e00031–e00019. doi: 10.1128/CMR.00031-19. - DOI - PMC - PubMed

MeSH terms