Emergence of Ceftazidime-Avibactam Resistance Due to Plasmid-Borne bla_KPC-3 Mutations during Treatment of Carbapenem-Resistant Klebsiella pneumoniae Infections.

ABSTRACT: Ceftazidime-avibactam is a novel β-lactam/β-lactamase inhibitor with activity against carbapenem-resistant Enterobacteriaceae (CRE) that produce Klebsiella pneumoniae carbapenemase (KPC). We report the first cases of ceftazidime-avibactam resistance to develop during treatment of CRE infections and identify resistance mechanisms. Ceftazidime-avibactam-resistant K. pneumoniae emerged in three patients after ceftazidime-avibactam treatment for 10 to 19 days. Whole-genome sequencing (WGS) of longitudinal ceftazidime-avibactam-susceptible and -resistant K. pneumoniae isolates was used to identify potential resistance mechanisms. WGS identified mutations in plasmid-borne bla_KPC-3, which were not present in baseline isolates. bla_KPC-3

SUBMITTER: Shields RK 

PROVIDER: S-EPMC5328542 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature