Emergence of ceftazidime-avibactam resistance through distinct genomic adaptations in KPC-2-producingKlebsiella pneumoniaeof sequence type 39 during treatment

Three ceftazidime-avibactam-resistant KPC-2-producingKlebsiella pneumoniaestrains 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 omega 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.

Automated summary

Three ceftazidime-avibactam-resistant KPC-2-producing Klebsiella pneumoniae strains of ST39 were isolated in Greece, with two strains corresponding to KPC-33 and KPC-57, and the third strain corresponding to KPC-44.