TY - JOUR
TI - Emergence of ceftazidime-avibactam resistance through distinct genomic adaptations in KPC-2-producing Klebsiella pneumoniae of sequence type 39 during treatment
AU - Galani, I.
AU - Karaiskos, I.
AU - Angelidis, E.
AU - Papoutsaki, V.
AU - Galani, L.
AU - Souli, M.
AU - Antoniadou, A.
AU - Giamarellou, H.
JO - European Journal of Clinical Microbiology and Infectious Diseases
PY - 2021
VL - 40
TODO - 1
SP - 219-224
PB - Springer Science and Business Media Deutschland GmbH
SN - null
TODO - 10.1007/s10096-020-04000-9
TODO - amikacin;  avibactam;  avibactam plus ceftazidime;  aztreonam;  beta lactamase;  beta lactamase KPC 2;  carbapenem derivative;  carbapenemase;  cefepime;  ceftazidime;  ceftriaxone;  chloramphenicol;  ciprofloxacin;  colistin;  cotrimoxazole;  fosfomycin;  gentamicin;  imipenem;  levofloxacin;  meropenem;  meropenem plus vaborbactam;  piperacillin plus tazobactam;  porin;  relebactam;  sulfonamide;  tetracycline;  tigecycline;  trimethoprim;  unclassified drug;  antiinfective agent;  avibactam, ceftazidime drug combination;  azabicyclo derivative;  ceftazidime, adaptation;  amikacin resistance;  amino acid substitution;  antibiotic sensitivity;  Article;  bacterial genome;  bacterium culture;  bacterium isolation;  beta-lactam resistance;  carbapenem resistance;  chromosome;  controlled study;  extensive drug resistance;  feces culture;  gene mutation;  genetic variation;  Greece;  hospitalization;  human;  intensive care unit;  Klebsiella pneumoniae;  Klebsiella pneumoniae infection;  minimum inhibitory concentration;  missense mutation;  monotherapy;  multidrug resistance;  nonhuman;  polymerase chain reaction;  priority journal;  promoter region;  rectal swab;  replicon;  tertiary care center;  transposon;  whole genome sequencing;  case report;  drug combination;  drug effect;  genetics;  Klebsiella infection;  Klebsiella pneumoniae;  microbial sensitivity test;  microbiology;  multidrug resistance;  rectum, Anti-Bacterial Agents;  Azabicyclo Compounds;  Ceftazidime;  Drug Combinations;  Drug Resistance, Multiple, Bacterial;  Greece;  Humans;  Klebsiella Infections;  Klebsiella pneumoniae;  Microbial Sensitivity Tests;  Rectum
TODO - 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. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
ER -