Emergence of Resistance to Colistin During the Treatment of Bloodstream Infection Caused by Klebsiella pneumoniae Carbapenemase–Producing Klebsiella pneumoniae. (23rd April 2018)

• Record Type: Journal Article
• Authors: Kanwar, Anubhav; Marshall, Steven H; Perez, Federico; Tomas, Myreen; Jacobs, Michael R; Hujer, Andrea M; Domitrovic, T Nicholas; Rudin, Susan D; Rojas, Laura J; Kreiswirth, Barry N; Chen, Liang; Quinones-Mateu, Miguel; van Duin, David; Bonomo, Robert A
• Is Part Of: Open forum infectious diseases. Volume 5:Number 4(2018)
• Publication Date: 2018-04-23
• Subjects: carbapenemase -- colistin resistance -- Klebsiella pneumoniae; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofy054
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: We report the emergence of colistin resistance in Klebsiella pneumoniae carbapenemase (KPC)–producing Klebsiella pneumoniae after 8 days of colistin-based therapy, resulting in relapse of bloodstream infection and death. Disruption of the mgrB gene by insertion of a mobile genetic element was found to be the mechanism, which was replicated in vitro after exposure to subinhibitory concentrations of colistin and meropenem.