Evolution of Imipenem-Relebactam Resistance Following Treatment of Multidrug-Resistant <i>Pseudomonas aeruginosa</i> Pneumonia
Ryan K. Shields, Madison E. Stellfox, Ellen G Kline, Palash Samanta, Daria Van Tyne
Abstract
We report the emergence of imipenem-relebactam nonsusceptible Pseudomonas aeruginosa in 5 patients treated for nosocomial pneumonia for 10-28 days. Genome sequence analysis identified treatment-emergent mutations in MexAB-OprM and/or MexEF-OprN efflux operons that arose independently in each patient across distinct P. aeruginosa sequence types. Testing with efflux-inhibitor PAβN restored imipenem-relebactam susceptibility.
Topics & Concepts
Pseudomonas aeruginosaEffluxImipenemMicrobiologyMedicinePneumoniaMultiple drug resistanceAntibacterial agentAntibioticsAntibiotic resistanceBiologyBacteriaGeneticsInternal medicineAntibiotic Resistance in BacteriaPneumonia and Respiratory InfectionsAntibiotics Pharmacokinetics and Efficacy