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First detection of autochthonous extensively drug-resistant NDM-1 Pseudomonas aeruginosa ST235 from a patient with bloodstream infection in Italy, October 2019. 2020

Daniela Loconsole, and Marisa Accogli, and Monica Monaco, and Maria Del Grosso, and Anna Lisa De Robertis, and Anna Morea, and Loredana Capozzi, and Laura Del Sambro, and Annarosa Simone, and Vincenzo De Letteriis, and Michele Quarto, and Antonio Parisi, and Maria Chironna
Department of Biomedical Sciences and Human Oncology, Hygiene Unit, University of Bari "Aldo Moro", P.zza G. Cesare 11, 70124, Bari, Italy.

Pseudomonas aeruginosa (PA) is one of the most common and serious causes of healthcare-associated bacteremia. The emergence and dissemination of multidrug-resistant (MDR) and extensively drug-resistant (XDR) PA strains pose a major clinical concern. ST235-PA is a high-risk clone which shows a high capacity to acquire antibiotic resistance. Here we describe the first autochthonous New Delhi metallo-β-lactamase (NDM)-producing Pseudomonas aeruginosa ST235 identified in Italy. In October 2019, a patient residing in an elderly health care and rehabilitation facility, was hospitalized and died from sepsis caused by an XDR-PA. The strain belonged to the high-risk clone sequence type ST235. Whole genome sequencing (WGS) revealed the presence of genes encoding NDM-1 and multiple β-lactamases, many clinically significant multidrug efflux pump complexes and also the virulence gene ExoU, which is associated with a high cytotoxic phenotype. Few strains of NDM-1-PA have been identified worldwide, all belonging to ST235. The combination of ST235 and ExoU is a predictor of highly unfavorable prognosis. The potential spread of these high-risk clones in healthcare settings is worrisome because treatment options are limited. Early identification of high-risk clones could help in outbreaks investigation and infections control.

UI MeSH Term Description Entries
D007558 Italy A country in southern Europe, a peninsula extending into the central Mediterranean Sea, northeast of Tunisia. The capital is Rome. Sardinia
D011550 Pseudomonas aeruginosa A species of gram-negative, aerobic, rod-shaped bacteria commonly isolated from clinical specimens (wound, burn, and urinary tract infections). It is also found widely distributed in soil and water. P. aeruginosa is a major agent of nosocomial infection. Bacillus aeruginosus,Bacillus pyocyaneus,Bacterium aeruginosum,Bacterium pyocyaneum,Micrococcus pyocyaneus,Pseudomonas polycolor,Pseudomonas pyocyanea
D011552 Pseudomonas Infections Infections with bacteria of the genus PSEUDOMONAS. Infections, Pseudomonas,Pseudomonas aeruginosa Infection,Infection, Pseudomonas,Pseudomonas Infection,Pseudomonas aeruginosa Infections
D005260 Female Females
D006299 Health Services for the Aged Services for the diagnosis and treatment of diseases in the AGED and the maintenance of health in the ELDERLY. Age-Friendly Health Care,Age-Friendly Health Services,Age-Friendly Health Systems,Geriatric Health Care,Geriatric Health Services,Geriatric Health Systems,Health Care for the Aged,Health Systems for the Aged,Health Services for Aged,Health Services for the Elderly,Health Services, Geriatric,Age Friendly Health Care,Age Friendly Health Services,Age Friendly Health Systems,Age-Friendly Health Cares,Age-Friendly Health Service,Age-Friendly Health System,Care, Age-Friendly Health,Care, Geriatric Health,Cares, Age-Friendly Health,Cares, Geriatric Health,Geriatric Health Cares,Geriatric Health Service,Geriatric Health System,Health Care, Age-Friendly,Health Care, Geriatric,Health Cares, Age-Friendly,Health Cares, Geriatric,Health Service, Age-Friendly,Health Service, Geriatric,Health Services, Age-Friendly,Health System, Age-Friendly,Health System, Geriatric,Health Systems, Age-Friendly,Health Systems, Geriatric,Service, Age-Friendly Health,Service, Geriatric Health,Services, Age-Friendly Health,Services, Geriatric Health,System, Age-Friendly Health,System, Geriatric Health,Systems, Age-Friendly Health,Systems, Geriatric Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001618 beta-Lactamases Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. beta-Lactamase,beta Lactamase,beta Lactamases
D017809 Fatal Outcome Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept. Fatal Outcomes,Outcome, Fatal,Outcomes, Fatal
D018805 Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK. Bloodstream Infection,Pyaemia,Pyemia,Pyohemia,Blood Poisoning,Poisoning, Blood,Septicemia,Severe Sepsis,Blood Poisonings,Bloodstream Infections,Infection, Bloodstream,Poisonings, Blood,Pyaemias,Pyemias,Pyohemias,Sepsis, Severe,Septicemias

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