Case Commentary: When Voldemort Meets Sauron: Treatment Considerations for Emerging Dual-Carbapenemase-Producing Extensively Drug-Resistant Pseudomonas aeruginosa

Antimicrob Agents Chemother. 2023 Jul 18;67(7):e0047523. doi: 10.1128/aac.00475-23. Epub 2023 Jun 13.

Abstract

Infections caused by extensively drug-resistant Pseudomonas aeruginosa are difficult to treat due to limited effective treatment options. In this issue, a patient with a corneal infection caused by a Verona integron-encoded metallo-β-lactamase (VIM)- and Guiana extended-spectrum β-lactamase (GES)-coproducing P. aeruginosa strain associated with the recent artificial tears-related outbreak in the United States is described. This resistance genotype/phenotype further compromises therapeutic options, and this report provides insights into diagnostic and treatment approaches for clinicians dealing with infections due to this highly resistant P. aeruginosa.

Keywords: Pseudomonas aeruginosa; artificial tears; carbapenemase; corneal ulcer; extensive drug resistance; multidrug resistance.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics
  • Bacterial Proteins / pharmacology
  • Humans
  • Microbial Sensitivity Tests
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas Infections* / epidemiology
  • Pseudomonas aeruginosa* / genetics
  • beta-Lactamases / genetics
  • beta-Lactamases / pharmacology

Substances

  • carbapenemase
  • beta-Lactamases
  • Bacterial Proteins
  • Anti-Bacterial Agents