We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Successful Treatment of an AML Patient Infected with Hypervirulent ST463 Pseudomonas Aeruginosa Harboring Rare Carbapenem-Resistant Genes blaAFM-1 and blaKPC-2 Following Allogeneic Hematopoietic Stem Cell Transplantation.
- Authors
Shen, Yingying; Cao, Junmin; Hu, Tonglin; Yang, Xiawan; Zhao, Yuechao; Shen, Yiping; Ye, Baodong; Yu, Yunsong; Wu, Dijiong
- Abstract
Background: Carbapenem-resistant P. aeruginosa (CRPA) is a common hospital-acquired bacterium. It exhibits high resistance to many antibiotics, including ceftazidime/avibactam and cefteolozane/tazobactam. The presence of carbapenem-resistant genes and co-existence Klebsiella pneumoniae carbapenemase (KPC) and metallo-β-lactamases (MBLs) further inactivated all β-lactams. Understanding the resistance genes of CRPA can help in uncovering the resistance mechanism and guiding anti-infective treatment. Herein, we reported a case of perianal infection with hypervirulent ST463 Pseudomonas aeruginosa. Case Presentation: The case is a 32-year-old acute myeloid leukemia (AML) patient with fever and septic shock during hematopoietic stem cell transplantation (HSCT), and the pathogen was finally identified as a highly virulent sequence type 463 (ST463) P. aeruginosa harboring carbapenem-resistant genes blaAFM-1 and blaKPC-2, which was detected in the bloodstream and originated from a perianal infection. The strain was resistant to ceftazidime/avibactam but successfully treated with polymyxin B, surgical debridement, and granulocyte engraftment after HSCT. The AML was cured during the 19-month follow-up. Conclusion: This case emphasizes the importance of metagenomic next-generation sequencing (mNGS) and whole-genome sequencing (WGS) in identifying microbes with rare resistant genes, and managing CRPA, especially in immunocompromised patients. Polymyxin B may be the least resistant option.
- Subjects
HEMATOPOIETIC stem cell transplantation; PSEUDOMONAS aeruginosa; QUORUM sensing; WHOLE genome sequencing; TREATMENT effectiveness; ACUTE myeloid leukemia; ARACHNOID cysts
- Publication
Infection & Drug Resistance, 2024, Vol 17, p1357
- ISSN
1178-6973
- Publication type
Case Study
- DOI
10.2147/IDR.S455746