Evolution of Imipenem-Relebactam Resistance Following Treatment of Multidrug-Resistant Pseudomonas aeruginosa Pneumonia

Clin Infect Dis. 2022 Sep 10;75(4):710-714. doi: 10.1093/cid/ciac097.

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.

Keywords: Pseudomonas; ceftolozane-tazobactam; efflux; imipenem-relebactam; resistance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Azabicyclo Compounds
  • Humans
  • Imipenem / pharmacology
  • Imipenem / therapeutic use
  • Microbial Sensitivity Tests
  • Pneumonia*
  • Pseudomonas aeruginosa* / genetics

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Imipenem
  • relebactam