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Clinical outcome from hematopoietic cell transplant patients with bloodstream infection caused by carbapenem-resistant P. aeruginosa and the impact of antimicrobial combination in vitro

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Abstract

Bloodstream infection (BSI) caused by carbapenem-resistant P. aeruginosa (CRPA) has high mortality in hematopoietic stem cell transplant (HSCT) recipients. We performed MIC, checkerboard, time-kill assay, PFGE, PCR, and whole genome sequence and described the clinical outcome through Epi Info comparing the antimicrobial combination in vitro. Mortality was higher in BSI caused by CRPA carrying the lasB virulence gene. The isolates were 97% resistant to meropenem displaying synergistic effect to 57% in combination with colistin. Seventy-three percent of the isolates harbored blaSPM-1 and Tn4371 and belonged to ST277. The synergistic effect in vitro with meropenem with colistin appeared to be a better therapeutic option.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Internal funding from the University of São Paulo, Brazil, and the National Council of Technological and Scientific Development (CNPQ), Brazil, supported this study.

Author information

Authors and Affiliations

  1. Department of Infectious Diseases of Faculdade de Medicina, University of Sao Paulo, São Paulo, Brazil

    Jessica Fernandes Ramos, Thais Guimarães, Anna Sara Levin & Silvia Figueiredo Costa

  2. Department of Haematology, Hemotherapy and Cellular Therapy of Faculdade de Medicina, University of Sao Paulo, São Paulo, Brazil

    Jessica Fernandes Ramos & Vanderson Rocha

  3. Laboratory of Medical Investigation - LIM 49 - Medical Tropical Institute, University of Sao Paulo, São Paulo, Brazil

    Gleice Leite, Roberta Cristina Ruedas Martins, Camila Rizek, Thais Guimarães, Anna Sara Levin & Silvia Figueiredo Costa

  4. Laboratory of Medical Investigation - LIM 52 - Medical Tropical Institute, University of Sao Paulo, São Paulo, Brazil

    Sabri Saeed Al Sanabani

  5. Laboratory of Clinical Microbiology of Hospital das Clínicas, Faculdade de Medicina, University of Sao Paulo, São Paulo, Brazil

    Flavia Rossi

  6. Haematology Department, NHS BT, Oxford University, Oxford, UK

    Vanderson Rocha

Authors
  1. Jessica Fernandes Ramos
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  2. Gleice Leite
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  3. Roberta Cristina Ruedas Martins
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  4. Camila Rizek
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  7. Thais Guimarães
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  8. Anna Sara Levin
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  9. Vanderson Rocha
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  10. Silvia Figueiredo Costa
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Contributions

JR assembled the data and drafted the manuscript. GCL and CR helped in MIC determination and synergy; RCR and SS were responsible for whole genome sequencing and bioinformatics analysis; TG, ASL, and VR helped with the draft of manuscript; and SFC designed and supervised the study, did analysis and interpretation, and drafted the manuscript. All authors have read, contributed, and approved the final manuscript.

Corresponding author

Correspondence to Gleice Leite.

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These experiments were approved by the Ethical Committee of Hospital das Clinicas of University of Sao Paulo and received approval by CONEP (National Ethics Commission), Brazil.

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The authors declare no competing interests.

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Ramos, J.F., Leite, G., Martins, R.C.R. et al. Clinical outcome from hematopoietic cell transplant patients with bloodstream infection caused by carbapenem-resistant P. aeruginosa and the impact of antimicrobial combination in vitro. Eur J Clin Microbiol Infect Dis 41, 313–317 (2022). https://doi.org/10.1007/s10096-021-04361-9

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  • DOI: https://doi.org/10.1007/s10096-021-04361-9

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