An Unusual Carbapenem Resistant Escherichia coli Carrying Plasmid-mediated AmpC and Mutated ompC in A Patient with Recurrent Urinary Tract Infections
Paige M.K. Larkin,
Susan Realegeno,
Kevin W. Ward,
Omai B. Garner,
Shangxin Yang
Affiliations
Paige M.K. Larkin
Department of Pathology & Laboratory Medicine, University of California, 11633 San Vicente Blvd, Los Angeles, CA 90049, United States
Susan Realegeno
Department of Pathology & Laboratory Medicine, University of California, 11633 San Vicente Blvd, Los Angeles, CA 90049, United States
Kevin W. Ward
Department of Pathology & Laboratory Medicine, University of California, 11633 San Vicente Blvd, Los Angeles, CA 90049, United States
Omai B. Garner
Department of Pathology & Laboratory Medicine, University of California, 11633 San Vicente Blvd, Los Angeles, CA 90049, United States
Shangxin Yang
Corresponding author at: 11633 San Vicente Blvd, UCLA Clinical Microbiology Laboratory, Los Angeles, CA 90049, United States.; Department of Pathology & Laboratory Medicine, University of California, 11633 San Vicente Blvd, Los Angeles, CA 90049, United States
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 blaCMY-2, 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.
