Postneurosurgical Meningitis Due to Proteus penneri with Selection of a Ceftriaxone-Resistant Isolate: Analysis of Chromosomal Class A β-Lactamase HugA and its LysR-Type Regulatory Protein HugR
ABSTRACT We report on a case of a postneurosurgical meningitis due to ceftriaxone-susceptible Proteus penneri, with selection of a ceftriaxone-resistant isolate following treatment with ceftriaxone. The isolates presented identical patterns by pulsed-field gel electrophoresis and produced a single β-lactamase named HugA with an isoelectric point of 6.7. The ceftriaxone-resistant isolate hyperproduced the β-lactamase (increase in the level of production, about 90-fold). The sequences of the hugA β-lactamase gene and its regulator, hugR, were identical in both P. penneri strains and had 85.96% homology with those of Proteus vulgaris. The HugA β-lactamase belongs to molecular class A, and the transcriptional regulator HugR belongs to the LysR family.