Emergence of Ceftolozane-Tazobactam-Resistant Pseudomonas aeruginosa during Treatment Is Mediated by a Single AmpC Structural Mutation

Antimicrob Agents Chemother. 2017 Nov 22;61(12):e01183-17. doi: 10.1128/AAC.01183-17. Print 2017 Dec.

Abstract

Ceftolozane-tazobactam is a cephalosporin-β-lactamase inhibitor combination that exhibits potent in vitro activity against Pseudomonas aeruginosa, including strains that are resistant to other β-lactams. The emergence of ceftolozane-tazobactam resistance among clinical isolates of P. aeruginosa has rarely been described. Here we characterized ceftolozane-tazobactam-resistant P. aeruginosa strains recovered from a patient who was treated with this agent for 6 weeks for a recurrent wound infection. The results showed that the resistance was mediated by a single AmpC structural mutation.

Keywords: AmpC; G183D; Pseudomonas aeruginosa; ceftolozane-tazobactam.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / genetics*
  • Cephalosporins / therapeutic use*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Penicillanic Acid / analogs & derivatives*
  • Penicillanic Acid / therapeutic use
  • Polymorphism, Single Nucleotide / genetics
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / genetics*
  • Tazobactam
  • Wound Infection / drug therapy
  • Wound Infection / microbiology
  • beta-Lactamase Inhibitors / therapeutic use*
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Cephalosporins
  • beta-Lactamase Inhibitors
  • ceftolozane, tazobactam drug combination
  • Penicillanic Acid
  • AmpC beta-lactamases
  • beta-Lactamases
  • Tazobactam