Pan-drug resistant Providencia rettgeri contributing to a fatal case of COVID-19

Abstract

Following prolonged hospitalization that included broad-spectrum antibiotic exposure, a strain of <i>Providencia rettgeri</i> was cultured from the blood of a patient undergoing extracorporeal membrane oxygenation treatment for hypoxic respiratory failure due to COVID-19. The strain was resistant to all antimicrobials tested including the novel siderophore cephalosporin, cefiderocol. Whole genome sequencing detected ten antimicrobial resistance genes, including the metallo-β-lactamase <i>bla</i> _NDM-1, the extended-spectrum β-lactamase <i>bla</i> _PER-1, and the rare 16S methyltransferase <i>rmtB2</i>.