Abstract
In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.
Keywords:
Klebsiella pneumoniae; carbapenem; ceftazidime-avibactam; resistance; whole-genome sequencing, KPC-2.
MeSH terms
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Anti-Bacterial Agents / therapeutic use*
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Azabicyclo Compounds / therapeutic use
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Bacterial Proteins / metabolism
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Ceftazidime / therapeutic use
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Drug Combinations
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Drug Resistance, Bacterial
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Humans
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Klebsiella Infections / diagnosis
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Klebsiella Infections / drug therapy*
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Klebsiella pneumoniae / drug effects*
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Klebsiella pneumoniae / genetics*
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Klebsiella pneumoniae / isolation & purification
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Microbial Sensitivity Tests
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Treatment Outcome
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*
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beta-Lactamase Inhibitors / therapeutic use
Substances
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Anti-Bacterial Agents
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Azabicyclo Compounds
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Bacterial Proteins
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Drug Combinations
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avibactam, ceftazidime drug combination
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beta-Lactamase Inhibitors
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Trimethoprim, Sulfamethoxazole Drug Combination
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Ceftazidime