KPC-2 producing Pseudomonas putida as an unexpected pathogen of catheter-associated bloodstream infection

J Infect Dev Ctries. 2020 Apr 30;14(4):411-414. doi: 10.3855/jidc.12145.

Abstract

Infections due to multidrug resistant Gram-negative pathogens are of great concern worldwide, as they are frequently associated with high mortality and morbidity rates. The occurrence of Pseudomonas spp. producing Klebsiella pneumoniae carbapenemases (KPCs) imposes a great challenge through treatment course of bloodstream infections (BSIs). Pseudomonas putida has been recognized as an emerging pathogen of healthcare associated infections (HAIs). Therefore, we aimed to report a case of a non-fatal case of peripheral line associated BSI (PLA-BSI) in an immunocompromised host due to P. putida harboring blaKPC-2 gene in Brazil. A P. putida isolate was recovered from a blood culture of a 72-year-old man admitted at a University Hospital, identified by BD Phoenix™ 100 (Becton, Dickinson and Company), causing PLA-BSI. The species identification was confirmed by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and resistance to carbapenems were confirmed by Epsilometer test (E-test®). Additionally, the presence of important carbapenemases genes (blaKPC, blaNDM, blaOXA-48-like, blaSPM, blaIMP, blaVIM) was investigated by Polymerase Chain Reaction. The bacterial isolate was confirmed as meropenem resistant P. putida harboring blaKPC-2 gene.Thereofre, these fidings suggest that P. putida can work as a reservoir for resistance genes as this bacterium has the ability to disseminate through water-fluids inside hospital and community settings. Moreover, this paper highlights that a frequent and worldwide disseminated mechanism of resistance (blaKPC-2) is currently occurring among uncommon agents of BSI.

Keywords: Bloodstream infection; KPC; Klebsiella pneumoniae carbapenemase; Pseudomonas putida.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Brazil
  • Carbapenems / pharmacology
  • Catheter-Related Infections / diagnosis
  • Catheter-Related Infections / microbiology*
  • Drug Resistance, Bacterial / genetics*
  • Humans
  • Immunocompromised Host
  • Male
  • Pseudomonas putida / enzymology
  • Pseudomonas putida / pathogenicity*
  • Sepsis / diagnosis
  • Sepsis / microbiology*
  • beta-Lactamases

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • beta-lactamase KPC-2
  • beta-Lactamases