{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:40:17Z","timestamp":1790239217175,"version":"4.1.0"},"reference-count":22,"publisher":"Microbiology Society","issue":"7","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold>\n                  <jats:italic>Pseudomonas aeruginosa<\/jats:italic> has the ability to acquire plasmids and other mobile genetic elements that confer resistance to antibiotics. Bacterial genes encoding different \u03b2-lactamases (bla), such as metallo-\u03b2-lactamases (MBLs) and extended-spectrum \u03b2-lactamases (ESBL), can confer resistance to multiple classes of \u03b2-lactam antibiotics.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Case presentation.<\/jats:bold> An 83\u2009year old female was admitted in 2012 to the Peruvian Naval Hospital, Centro M\u00e9dico Naval \u2018Cirujano Mayor Santiago T\u00e1vara\u2019 (CEMENA), in Lima, Peru. A midstream urine sample was collected and sent to the local CEMENA laboratory for routine urine culture. <jats:italic>P. aeruginosa<\/jats:italic> was isolated and initial antibiotic susceptibility testing showed it to be sensitive to imipenem. The clinicians started a course of meropenem, but the patient did not improve. After 5\u2009days, a second urine culture was performed and a <jats:italic>P. aeruginosa<\/jats:italic> was isolated again, but this time the strain showed resistance to imipenem. The treatment course was changed to fosfomycin and the patient improved. Phenotypic and molecular laboratory testing to characterize the antibiotic resistance were performed, demonstrating the presence of both MBL and ESBL genes.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion.<\/jats:bold> To our knowledge, this is the first report of a <jats:italic>P. aeruginosa<\/jats:italic> XDR clinical isolate that co-expresses an MBL (VIM-2), OXA-1 beta-lactamase and the ESBL (GES-1) in Peru. It is also the first report of a VIM carbapenemase in Peru.<\/jats:p>","DOI":"10.1099\/jmmcr.0.005154","type":"journal-article","created":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T13:12:44Z","timestamp":1529586764000},"source":"Crossref","is-referenced-by-count":14,"title":["Extensively drug-resistant (XDR) Pseudomonas aeruginosa identified in Lima, Peru co-expressing a VIM-2 metallo-\u03b2-lactamase, OXA-1 \u03b2-lactamase and GES-1 extended-spectrum \u03b2-lactamase"],"prefix":"10.1099","volume":"5","author":[{"given":"Paul","family":"R\u00edos","sequence":"first","affiliation":[{"name":"1\u200bU.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Rocha","sequence":"additional","affiliation":[{"name":"1\u200bU.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Castro","sequence":"additional","affiliation":[{"name":"2\u200bCentro M\u00e9dico Naval \u201cCirujano Mayor Santiago T\u00e1vara (CEMENA)\u201d, Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Vidal","sequence":"additional","affiliation":[{"name":"2\u200bCentro M\u00e9dico Naval \u201cCirujano Mayor Santiago T\u00e1vara (CEMENA)\u201d, Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Canal","sequence":"additional","affiliation":[{"name":"1\u200bU.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Bernal","sequence":"additional","affiliation":[{"name":"1\u200bU.S. Naval Medical Research Unit No.6 (NAMRU-6), Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathanael 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