Unusual carbapenem resistant but ceftriaxone and cefepime susceptible Klebsiella oxytoca isolated from a blood culture: Case report and whole-genome sequencing investigation. (2018)

• Record Type: Journal Article
• Authors: Yang, Shangxin; Hemarajata, Peera; Shevy, Laura; Maciariello, Mario; Culbreath, Karissa; Bush, Karen; Humphries, Romney
• Is Part Of: IDCases. Volume 11(2017)
• Page Start: 9
• Page End: 11
• Publication Date: 2018
• Subjects: Carbapenem resistance -- Klebsiella oxytoca -- blaOXY -- Porin mutation -- Efflux system -- Whole-genome sequencing; Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2017.11.007
• Languages: English
• ISSNs: 2214-2509

Abstract

Abstract: A carbapenem resistant but ceftriaxone and cefepime susceptible Klebsiella oxytoca was isolated from the blood of a patient with polymicrobial bacteremia after 2 weeks of ertapenem treatment. Whole-genome sequencing identified no carbapenemase gene nor plasmid, but only bla OXY-2-8 gene with a mutation in the promoter that's been reported to increase its expression. Two other specific carbapenem resistance mechanisms including mutated porin genes and the AcrAB-TolC efflux system genes were also identified. Clinicians need to be aware of such unusual antibiogram and should not assume carbapenems are always broader spectrum antibiotics than expanded-spectrum cephalosporins.