ASM case reports最新文献

{"title":"Meningitis in a French pig farmer caused by a serotype 2 <i>Streptococcus suis</i> isolate from the uncommon ST25 lineage.","authors":"M'hensa Vincent De Paul Bakpatina-Batako, Hubert Gantelet, Eric Lewandowski, Rodolphe Buzelé, Alain Delépine, Evelyne Gaillard, Sonia Lacouture, Kevin Li, Marcelo Gottschalk, Nahuel Fittipaldi","doi":"10.1128/asmcr.00234-25","DOIUrl":"10.1128/asmcr.00234-25","url":null,"abstract":"<p><strong>Background: </strong>Human <i>Streptococcus suis</i> infections occur worldwide but are most common in East and Southeast Asia. In Europe, most cases are linked to occupational contact with pigs and are usually caused by serotype 2 sequence type 1 (ST1) and ST20 strains, whereas other serotype 2 genotypes seldom cause human disease on the continent.</p><p><strong>Case summary: </strong>A 55-year-old male pig farmer from Brittany, France, presented with acute confusion, fever, and nuchal rigidity consistent with meningitis. Cerebrospinal fluid cultures were negative, but blood cultures grew <i>S. suis</i>. Empirical treatment with cefotaxime and dexamethasone was initiated, followed by high-dose amoxicillin once antimicrobial susceptibility results confirmed β-lactam sensitivity. The patient required 5 days of intensive care and 7 additional days in a general ward and then completed 8 days of home intravenous ceftriaxone, fully recovering without hearing loss, a frequent sequela of <i>S. suis</i> meningitis. The isolate was typed as serotype 2. It belonged to the ST25 lineage and was genetically closely related to North American strains.</p><p><strong>Conclusion: </strong>This case serves as a reminder that <i>S. suis</i> should be considered in meningitis among swine-exposed individuals and expands the known range of ST25 human infections to Western Europe, providing useful insights for regional surveillance efforts.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedaquiline resistance: a predictable consequence of a game-changing drug?","authors":"Ronald Lubelchek","doi":"10.1128/asmcr.00228-25","DOIUrl":"10.1128/asmcr.00228-25","url":null,"abstract":"<p><p>Bedaquiline's (BDQ) incorporation into the recommended treatment for drug-resistant tuberculosis (DR-TB) has ushered in a new era of highly effective, shorter course, all-oral regimens. Unfortunately, as the uptake of BDQ-based regimens has increased, so has the emergence of BDQ resistance. In a recent <i>ASM Case Reports</i> article, M. Richard-Greenblatt, R. Bagga, C. Duncan, M. J. Billick, et al. (ASM Case Rep 2:e00126-25, 2025, https://doi.org/10.1128/asmcr.00126-25) reported on a patient with treatment-emergent extensively drug-resistant (XDR) TB, whose isolate harbored a novel loss-of-function <i>pepQ</i> mutation, with resulting BDQ resistance. This commentary briefly highlights the benefits of BDQ-based DR-TB therapy, while also reviewing data related to the growing challenge posed by BDQ resistance.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult <i>Fasciola</i> recovered from the biliary tree in a patient presenting with possible ascending cholangitis and acute acalculous cholecystitis.","authors":"Kaeli N Bryant, Eileen Burd, Adam Barker, Blaine A Mathison","doi":"10.1128/asmcr.00038-26","DOIUrl":"10.1128/asmcr.00038-26","url":null,"abstract":"<p><strong>Background: </strong>Fascioliasis is a zoonotic trematode infection caused by members of the genus <i>Fasciola</i> (<i>F. hepatica</i> and <i>F. gigantica</i>) that localize to the hepatic biliary ducts in humans. Parasites are acquired after ingestion of freshwater plants, and fascioliasis has been reported on every inhabited continent. Typically, fascioliasis is diagnosed by serology or stool examination. This case reports the unusual finding of adult <i>Fasciola</i> organisms during an endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Case summary: </strong>A 65-year-old woman who returned to the United States after traveling in Vietnam presented with abdominal pain, eosinophilia, and cholangitis. Filling defects/debris were detected in the common bile duct (CBD) upon imaging studies, so an ERCP was performed to investigate further. During the procedure, between three and four adult flukes were recovered from the biliary ducts and were later identified as <i>Fasciola</i> at a reference laboratory.</p><p><strong>Conclusion: </strong>The recovery of intact <i>Fasciola</i> during a surgical procedure is a highly unusual finding. It is crucial to accurately identify these organisms as there are numerous different species of liver flukes. Some flukes may resemble <i>Fasciola</i> at the egg or adult stage, such as <i>Fasciolopsis buski</i>. The treatment of <i>Fasciola</i> differs from that of all other liver flukes, as it is resistant to praziquantel and must be treated with triclabendazole, and improper treatment can lead to chronic complications.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges and therapeutic approach for aortic pseudoaneurysm infection with <i>Paenibacillus pueri</i>: a case report.","authors":"Jacob Owens, Lauren Jenkins, John S Stevenson, Cindy Schmidt, Jasmine R Marcelin","doi":"10.1128/asmcr.00229-25","DOIUrl":"10.1128/asmcr.00229-25","url":null,"abstract":"<p><strong>Background: </strong><i>Paenibacillus</i> species are rod-shaped, gram-variable, endospore-forming, environmental bacteria. Once classified within <i>Bacillus</i> spp., it was reclassified based on 16S rRNA sequencing. <i>Paenibacillus</i> spp. has rarely been found to be pathogenic in humans; however, recent reports have been described in immunocompromised patients.</p><p><strong>Case summary: </strong>A 60-year-old male with past medical history of hypertension, hyperlipidemia, atrial fibrillation, and bicuspid aortic valve presented to an outside hospital for 3 days of chest pain without associated symptoms. He was transferred to our institution after computed tomography (CT) demonstrated fluid around the aortic root concerning for aortic pseudoaneurysm. Admission and follow-up blood cultures were negative. He was started on ceftriaxone and vancomycin and underwent aortic root repair. Intraoperative cultures grew gram-indeterminate bacilli identified as <i>Paenibacillus pueri</i> by 16S broad-range PCR at an outside institution. Initial pathogen identification was complicated without discernible morphological differences between <i>Paenibacillus</i> spp. and <i>Bacillus</i> spp. Final identification often relies on molecular methods. Previous cases utilized amoxicillin-clavulanate or trimethoprim-sulfamethoxazole, with resistance demonstrated to penicillins and clindamycin. In our case, doxycycline was chosen based on limited susceptibility profiles and considering antibiotic side effect profiles.</p><p><strong>Conclusion: </strong>This is the third documented human case of <i>Paenibacillus pueri</i> infection. <i>Paenibacillus</i> spp. infections have varied clinical presentations, typically described in immunocompromised patients. This case demonstrates the difficulties in identifying <i>Paenibacillus pueri</i>. While rare, <i>Paenibacillus</i> spp. has been occasionally implicated in human disease. Even in immunocompetent patients, suspicion for true pathogens should remain high with repeated isolation on separate specimens.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When MALDI-TOF MS and 16S rRNA gene sequencing are not enough: identification of <i>Gordonia hongkongensis</i> causing bloodstream infection.","authors":"Ariel Gianecini, Maria Florencia Abeiro, Florencia Rocca, Sergio Daniele, Juan Francisco Losinno, Lucia Cipolla, Maria Virginia Gonzalez","doi":"10.1128/asmcr.00007-26","DOIUrl":"10.1128/asmcr.00007-26","url":null,"abstract":"<p><strong>Background: </strong><i>Gordonia</i> spp. are gram-positive aerobic bacilli whose infections in humans are rare and typically affect immunocompromised hosts and those with indwelling medical devices. Conventional identification systems frequently misidentify <i>Gordonia</i> species. Here, we present a bloodstream infection caused by <i>Gordonia hongkongensis</i>.</p><p><strong>Case summary: </strong>A 76-year-old man with metastatic colorectal adenocarcinoma receiving oral chemotherapy presented with febrile syndrome and acute diarrhea, unresponsive to prior antimicrobial therapy. Blood cultures were positive for gram-positive rods, which grew producing pink-to-orange pigmented colonies. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing could not distinguish the isolate at the species level, identifying it as belonging to the genus <i>Gordonia</i>. Owing to the limitations of these methods, whole-genome sequencing (WGS) was performed, which revealed <i>G. hongkongensis</i> as the causative pathogen. Updating the MALDI-TOF MS database with the main spectral profiles enabled the correct identification of the isolate upon reanalysis. Empirical antimicrobial therapy with piperacillin-tazobactam was initiated before organism identification and susceptibility testing. After a 7-day course of treatment, the patient showed clinical improvement and resolution of fever.</p><p><strong>Conclusion: </strong>Human infections with <i>G. hongkongensis</i> are rare. This case underscores the diagnostic challenges associated with <i>Gordonia</i> species and emphasizes the role of WGS in accurately identifying emerging pathogens. Increased awareness and improved diagnostic tools are essential for a better understanding and management of <i>Gordonia</i> infections.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-infection with macrolide-resistant and macrolide-susceptible <i>Bordetella pertussis</i> strains in an infant: a case report.","authors":"Kentaro Koide, Kaoru Ikeda, Kohei Osada, Yoshio Sakurai, Masataka Goto, Tsuyoshi Kenri, Nao Otsuka","doi":"10.1128/asmcr.00242-25","DOIUrl":"10.1128/asmcr.00242-25","url":null,"abstract":"<p><strong>Background: </strong><i>Bordetella pertussis</i> infection causes severe respiratory illness, particularly in young infants. Although macrolides are recommended as the first-line treatment, macrolide-resistant strains have emerged in several countries. In Japan, a nationwide pertussis epidemic occurred in 2025, during which numerous infections were reported not only due to macrolide-susceptible <i>B. pertussis</i> (MSBP) but also due to macrolide-resistant strains (MRBP).</p><p><strong>Case summary: </strong>A 2-month-old female developed a persistent cough and was admitted to the pediatric intensive care unit (PICU), where she received frequent suctioning and short-term high-flow nasal cannula therapy. BioFire FilmArray Respiratory Panel 2.1 analysis of her nasal swab detected <i>B. pertussis</i> DNA; azithromycin was therefore administered for 5 days. Direct sequencing of the DNA extracted from her nasal swabs initially indicated an A2047G mutation in the 23S rRNA gene of <i>B. pertussis,</i> indicating MRBP infection, although the electropherogram was unclear. Trimethoprim-sulfamethoxazole was initiated on day 8 of her PICU stay following confirmation of MRBP infection. Subsequently, bacterial culture yielded two different <i>B. pertussis</i> strains, which were confirmed as MRBP and MSBP through antimicrobial susceptibility testing. Multilocus variable-number tandem-repeat analysis and whole-genome analysis demonstrated that the strains were genetically unrelated. The patient was discharged and subsequently fully recovered after a 14 day course of trimethoprim-sulfamethoxazole.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first confirmed case of co-infection with MRBP and MSBP strains. Such mixed infections may be missed by the diagnostic methods currently used in clinical practice, highlighting the importance of careful interpretation of test results.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral amoxicillin-clavulanate: an alternative treatment to refractory <i>Nocardia</i> keratitis-a case report.","authors":"Prathishtha Pitchyaiah, Rachel A F Wozniak","doi":"10.1128/asmcr.00223-25","DOIUrl":"10.1128/asmcr.00223-25","url":null,"abstract":"<p><strong>Background: </strong>Bacterial keratitis (bacterial corneal infection) is a serious, vision-threatening disease caused by a wide range of bacterial species. The gram-positive bacterium <i>Nocardia</i> spp. is increasingly recognized in keratitis, yet is particularly challenging to treat due to delayed diagnosis and limited efficacy of current ophthalmic therapeutics. Antimicrobial resistance among clinical <i>Nocardia</i> isolates is also rising, further complicating patient outcomes. Herein, we report a case of <i>Nocardia amikacinitolerans</i> keratitis, resistant to amikacin, ciprofloxacin, moxifloxacin, clarithromycin, and ceftriaxone, resulting in a complicated therapeutic course.</p><p><strong>Case summary: </strong>A 53-year-old female presented with bacterial keratitis of the right eye, which over the course of 32 months progressed to scleritis (infection of the sclera) and a progressive, significant decrease in visual acuity to hand motion despite exhaustive topical and systemic antimicrobial therapies. While there is a general lack of efficacy of systemic therapies for bacterial keratitis, oral amoxicillin-clavulanate ultimately proved successful in resolving the infection.</p><p><strong>Conclusion: </strong>As <i>Nocardia</i> spp. ocular infections become more prevalent, this report underscores the highly virulent nature of this pathogen and provides insights into potential therapeutic modalities in the setting of multidrug resistance.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seronegative secondary syphilis in a patient with hematologic malignancy on anti-CD20 therapy: case report and review of serologic responses to spirochetal infection in patients receiving B-cell-depleting therapies.","authors":"Sheikh Abdullah, Alexandre E Malek, Elena Gonzalez Caldito, Ashley Flowers, Poornima Ramadas","doi":"10.1128/asmcr.00010-26","DOIUrl":"10.1128/asmcr.00010-26","url":null,"abstract":"<p><strong>Background: </strong>The expanding use of B-cell-depleting anti-CD20 monoclonal antibodies has introduced diagnostic challenges for infections that are traditionally confirmed through serologic testing. Seronegative secondary syphilis is exceptionally rare and has historically been described only in profoundly immunocompromised patients with advanced HIV/AIDS. This case represents a novel clinical scenario in the era of targeted immunologic therapy.</p><p><strong>Case summary: </strong>We report the case of a 44-year-old man with marginal zone lymphoma receiving maintenance obinutuzumab, who presented with a symmetric, pruritic, palmoplantar predominant papulosquamous eruption accompanied by fatigue and elevated inflammatory markers. Extensive serologic testing for syphilis, including repeated treponemal (TP-PA, treponemal IgG) and nontreponemal (RPR) assays, remained completely nonreactive on multiple occasions. However, a skin punch biopsy demonstrated epidermal hyperplasia with a dense plasma cell-rich lymphohistiocytic infiltrate. Immunohistochemical staining for <i>Treponema pallidum</i> revealed numerous spirochetes in the epidermis and superficial dermis, confirming the diagnosis of secondary syphilis. The patient received three weekly intramuscular doses of benzathine penicillin G (2.4 million units per dose) with complete clinical resolution and no adverse effects. Serologic tests remained nonreactive on follow-up evaluation.</p><p><strong>Conclusion: </strong>This case is the first documented report of persistent seronegative secondary syphilis in a patient receiving obinutuzumab therapy. It underscores the critical importance of maintaining a high index of clinical suspicion and pursuing tissue-based diagnostics when serologic tests fail to explain compelling clinical findings in patients with profound B-cell depletion. Clinicians managing patients on anti-CD20 therapies must recognize the limitations of serologic diagnosis for infections that typically depend on antibody detection.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory <i>Candidozyma</i> (<i>Candida</i>) <i>auris</i>-associated central nervous system infection in a postoperative neurosurgical patient.","authors":"Yuan Chao Xue, Khadija Thomas, Noor Zaidan, Ping Ren","doi":"10.1128/asmcr.00008-26","DOIUrl":"10.1128/asmcr.00008-26","url":null,"abstract":"<p><strong>Background: </strong><i>Candidozyma</i> (<i>Candida</i>) <i>auris</i> has emerged as a global health threat because of its ability to persist on skin and environmental surfaces and its frequent resistance to multiple antifungal agents. We describe a rare but clinically significant case of <i>C. auris</i>-associated central nervous system (CNS) infection in a postoperative neurosurgical patient.</p><p><strong>Case summary: </strong>A 60-year-old woman developed a postoperative cerebrospinal fluid (CSF) leak following intradural lumbar tumor resection and was readmitted with headaches, neck pain, and nausea. CSF and wound cultures grew <i>C. auris</i>, while blood cultures remained negative, suggesting localized CNS involvement. Combination antifungal therapy with liposomal amphotericin B, flucytosine, and micafungin, later supplemented with posaconazole, was initiated but was complicated by significant toxicities requiring dose adjustments and stepwise discontinuation. Antifungal susceptibility testing demonstrated reduced susceptibility to amphotericin B, and <i>C. auris</i> was repeatedly isolated from CSF despite therapy. Given persistent recovery of the organism, the clinical team initiated the US Food and Drug Administration Single Patient IND process to obtain fosmanogepix, an investigational antifungal agent, although the request was ultimately discontinued as the patient clinically stabilized. She was discharged on long-term oral voriconazole for antifungal suppression because of persistent CSF isolation of <i>C. auris</i>, multidrug resistance, and limited CNS penetration of previously administered antifungals.</p><p><strong>Conclusion: </strong>This case highlights diagnostic uncertainty, therapeutic challenges, and antifungal decision-making complexities following isolation of <i>C. auris</i> from CSF.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Enterobacter roggenkampii</i> ST422 with highly conjugative IncP plasmid carrying <i>bla</i> _KPC-2 gene from Lebanon: a case report.","authors":"Souad Fayad, Dina Daaboul, Delphine Girlich, Monzer Hamze, Hassan Mallat, Laurent Dortet, Fouad Dabboussi, Issmat I Kassem, Bogdan I Iorga, Saoussen Oueslati, Marwan Osman, Thierry Naas","doi":"10.1128/asmcr.00239-25","DOIUrl":"10.1128/asmcr.00239-25","url":null,"abstract":"<p><strong>Background: </strong>The <i>Enterobacter cloacae</i> complex (ECC) includes opportunistic pathogens that can be carbapenem resistant, thus complicating treatment regimens. Here, we characterized a carbapenem- and colistin-resistant ECC O89H7 isolate expressing KPC carbapenemase.</p><p><strong>Case summary: </strong>ECC O89H7 was isolated in January 2021 from an axillary swab performed during routine screening for multidrug-resistant (MDR) bacteria from a patient after 39 days of hospitalization in the intensive care unit (ICU) for severe COVID-19 pneumonia at Nini hospital (Tripoli, Lebanon). The ECC O89H7 was identified as <i>E. roggenkampii</i> (<i>Er</i>) belonging to sequence type (ST)422 and contained eight different plasmids as revealed by whole-genome sequencing (WGS). <i>Er</i> O89H7 was predicted to be a human pathogen (96.3%), harboring 51 virulence factors as well as genes conferring resistance to heavy metals and quaternary ammonium compounds. <i>Er</i> O89H7 was highly drug resistant, including resistance to carbapenems and colistin. The resistome revealed six β-lactamase genes: the chromosome-encoded <i>bla</i> _MIR-3 cephalosporinase, <i>bla</i> _LAP-2 and <i>bla</i> _SHV-12 encoded on a 115-kb IncM-1 plasmid, and <i>bla</i> _OXA-10 <i>, bla</i> _TEM-40, and <i>bla</i> _KPC-2 on a mobilizable IncP-6 plasmid of 51 kb, as revealed by mating-out assays.</p><p><strong>Conclusion: </strong>Here, we have characterized a human pathogenic <i>Er</i> ST422 harboring <i>bla</i> _KPC-2 carbapenemase on an IncP-6 plasmid from Lebanon. <i>Er</i> O89H7 represents a major health threat due to limited therapeutic options, especially because novel β-lactam/inhibitor combinations are not available in Lebanon. Our results highlight an urgent need for improved carbapenemase screening and detection capacity in clinical laboratories and for enhanced genomic surveillance of MDR bacteria to implement intervention strategies to control their spread in Lebanon and beyond.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}