Abstract
Two ceftazidime-avibactam (CAZ-AVI)-resistant Klebsiella pneumoniae carbapenemase (KPC)-positive K. pneumoniae strains, including one pandrug resistant, were isolated in 2019 from two Greek hospitals. The strains were sequence types (ST)s 258 and 147 and both harboured similar self-transmissible IncA/C2 plasmids encoding a novel Lys234Arg variant of the Vietnamese extended-spectrum β-lactamase (VEB)-1, not inhibited by AVI (VEB-25). Conjugal transfer of VEB-25-encoding plasmids to Escherichia coli yielded CAZ-AVI-resistant clones, supporting that VEB-25 is directly linked to the derived phenotype.
Keywords:
Ceztazidime-avibactam; Klebsiella pneumoniae, pandrug; MDR; VEB β-lactamase; XDR; resistance.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Anti-Bacterial Agents / pharmacology*
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Anti-Bacterial Agents / therapeutic use
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Azabicyclo Compounds
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Bacterial Proteins / genetics
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Carbapenems / pharmacology*
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Ceftazidime
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Drug Combinations
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Drug Resistance, Bacterial
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Drug Resistance, Multiple, Bacterial / genetics*
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Genome, Bacterial
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Greece
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Humans
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Klebsiella Infections / drug therapy
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Klebsiella Infections / microbiology*
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Klebsiella pneumoniae / drug effects*
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Klebsiella pneumoniae / enzymology
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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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Mutation / genetics
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Plasmids
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Whole Genome Sequencing
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beta-Lactamases / genetics
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beta-Lactamases / metabolism*
Substances
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Anti-Bacterial Agents
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Azabicyclo Compounds
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Bacterial Proteins
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Carbapenems
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Drug Combinations
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avibactam, ceftazidime drug combination
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Ceftazidime
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beta-Lactamases