An Unusual Carbapenem Resistant Escherichia coli Carrying Plasmid-mediated AmpC and Mutated ompC in A Patient with Recurrent Urinary Tract Infections.
We describe a case of carbapenem resistant E. coli isolated from urine in an 87-year-old woman with recurrent urinary tract infections. Using whole genome sequencing (WGS), we identified the carbapenem resistance mechanism to be a combination of ompC porin loss and plasmid-mediated AmpC gene bla , which was not detected by routine molecular and phenotypic carbapenemase assays. Our case raises a concern for the limitation of current CRE screening tools for emerging resistance mechanisms and demonstrates the utility of WGS as a better tool for characterization of CRE in the clinical setting.
['Larkin|Paige M K|PMK|', 'Realegeno|Susan|S|', 'Ward|Kevin W|KW|', 'Garner|Omai B|OB|', 'Yang|Shangxin|S|']
Carbapenem resistant plasmid-mediated AmpC OmpC E. coli Porin loss AMR, Antimicrobial resistance CRE, Carbapenem resistant Enterobacterales Enterobacterales MHT, Modified Hodge test Omp, Outer membrane porin WGS, Whole genome sequencing blaCMY-2 mCIM, Modified carbapenem inactivation method pAmpC, Plasmid-mediated AmpC