Emergence of ceftazidime-avibactam resistance through distinct genomic adaptations in KPC-2-producing Klebsiella pneumoniae of sequence type 39 during treatment.
Irene GalaniIlias KaraiskosEvdokia AngelidisVassiliki PapoutsakiLamprini GalaniMaria SouliAnastasia AntoniadouHelen GiamarellouPublished in: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (2020)
Three ceftazidime-avibactam-resistant KPC-2-producing Klebsiella pneumoniae strains of ST39 were isolated in Greece, from rectal swabs of three patients after 10-15 days of treatment. The patients were treated with ceftazidime-avibactam as monotherapy or in combination with colistin. Two of these strains harbored a D179Y or a D179V substitution in the Ω loop of KPC-2, corresponding to KPC-33, or to the novel KPC-57, respectively. The third strain had a 15 amino acid insertion after position 259 in the KPC-2, corresponding to KPC-44.
Keyphrases
- klebsiella pneumoniae
- escherichia coli
- multidrug resistant
- gram negative
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- ejection fraction
- amino acid
- drug resistant
- prognostic factors
- acinetobacter baumannii
- randomized controlled trial
- gene expression
- high intensity
- pseudomonas aeruginosa
- patient reported outcomes
- open label
- rectal cancer
- dna methylation
- copy number
- cystic fibrosis