Resistance to ceftazidime-avibactam in a KPC-2-producing Klebsiella pneumoniae caused by the extended-spectrum beta-lactamase VEB-25

Eur J Clin Microbiol Infect Dis. 2023 May;42(5):639-644. doi: 10.1007/s10096-023-04582-0. Epub 2023 Mar 6.

Abstract

Carbapenem-resistant Enterobacterales, including KPC-producing Klebsiella pneumoniae, represent a major threat to public health due to their rapid spread. The beta-lactam/beta-lactamase inhibitor (BL/BLI) combination ceftazidime-avibactam (CAZ-AVI) has recently been introduced and shown to exhibit excellent activity toward multidrug-resistant KPC-producing Enterobacterales strains. However, CAZ-AVI-resistant K. pneumoniae isolates are being increasingly reported, mostly corresponding to producers of KPC variants that confer resistance to CAZ-AVI but at a cost of carbapenem resistance. We have characterized here, both phenotypically and genotypically, a clinical CAZ-AVI- and carbapenem-resistant KPC-2 K. pneumoniae isolate co-producing the inhibitor-resistant extended-spectrum beta-lactamase VEB-25.

Keywords: Ceftazidime-avibactam; KPC; Klebsiella pneumoniae; VEB.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics
  • Carbapenem-Resistant Enterobacteriaceae*
  • Carbapenems / pharmacology
  • Ceftazidime / pharmacology
  • Drug Combinations
  • Humans
  • Klebsiella Infections* / drug therapy
  • Klebsiella Infections* / microbiology
  • Klebsiella pneumoniae
  • Microbial Sensitivity Tests
  • beta-Lactamase Inhibitors / pharmacology
  • beta-Lactamase Inhibitors / therapeutic use
  • beta-Lactamases / genetics

Substances

  • avibactam, ceftazidime drug combination
  • Anti-Bacterial Agents
  • beta-Lactamases
  • Ceftazidime
  • Drug Combinations
  • Carbapenems
  • beta-Lactamase Inhibitors
  • Bacterial Proteins