Emergence and Recovery of Ceftazidime-avibactam Resistance in blaKPC-33-Harboring Klebsiella pneumoniae Sequence Type 11 Isolates in China

This is the first report of ceftazidime-avibactam resistance caused by the bla(KPC-33) mutation through the D179Y variant during the treatment of bla(KPC-2)-positive Klebsiella pneumoniae-related infections in China. The bla(KPC-33)-containing K. pneumoniae was susceptible to meropenem-vaborbactam, cefepime-zidebactam, tigecycline, and polymyxin B. The bla(KPC-33) gene was located on a 77 551-bp transformable plasmid harboring qnrS1 and bla(LAP-2). Detecting bla(KPC-33)-positive K. pneumoniae clinical strains is important for infection control.