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Recurrent Campylobacter jejuni Infections with In Vivo Selection of Resistance to Macrolides and Carbapenems: Molecular Characterization of Resistance Determinants.
- Source :
-
Microbiology spectrum [Microbiol Spectr] 2023 Aug 17; Vol. 11 (4), pp. e0107023. Date of Electronic Publication: 2023 Jun 26. - Publication Year :
- 2023
-
Abstract
- We present two independent cases of recurrent multidrug-resistant Campylobacter jejuni infection in immunocompromised hosts and the clinical challenges encountered due to the development of high-level carbapenem resistance. The mechanisms associated with this unusual resistance for Campylobacters were characterized. Initial macrolide and carbapenem-susceptible strains acquired resistance to erythromycin (MIC > 256mg/L), ertapenem (MIC > 32mg/L), and meropenem (MIC > 32mg/L) during treatment. Carbapenem-resistant isolates developed an in-frame insertion resulting in an extra Asp residue in the major outer membrane protein PorA, within the extracellular loop L3 that connects β-strands 5 and 6 and forms a constriction zone involved in Ca <superscript>2+</superscript> binding. The isolates presenting the highest MIC to ertapenem exhibited an extra nonsynonymous mutation (G167A|Gly56Asp) at PorA's extracellular loop L1. IMPORTANCE Carbapenem susceptibility patterns suggest drug impermeability, related to either insertion and/or single nucleotide polymorphism (SNP) within por A. Similar molecular events occurring in two independent cases support the association of these mechanisms with carbapenem resistance in Campylobacter spp.<br />Competing Interests: The authors declare no conflict of interest.
- Subjects :
- Humans
Macrolides pharmacology
Macrolides therapeutic use
Carbapenems pharmacology
Carbapenems therapeutic use
Ertapenem
Drug Resistance, Bacterial genetics
Anti-Bacterial Agents pharmacology
Anti-Bacterial Agents therapeutic use
Microbial Sensitivity Tests
Campylobacter jejuni genetics
Campylobacter Infections drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2165-0497
- Volume :
- 11
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Microbiology spectrum
- Publication Type :
- Academic Journal
- Accession number :
- 37358443
- Full Text :
- https://doi.org/10.1128/spectrum.01070-23