期刊
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
卷 61, 期 5, 页码 -出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/AAC.00079-17
关键词
carbapenem-resistant Enterobacteriaceae; Klebsiella pneumoniae carbapenemase; ceftazidime-avibactam resistance; sequence type 258 Klebsiella pneumoniae; KPC mutations
资金
- National Institutes of Health [K08AI114883, R21AI117338, R01AI090155, R21AI128338, R21AI111037]
Ceftazidime-avibactam resistance is mediated by bla(KPC-3) mutations, which restore carbapenem susceptibility. We subjected Klebsiella pneumoniae isolates with different bla(KPC-3) mutations (n=5) or wild-type bla(KPC-3) (n=2) to serial passages with meropenem. The meropenem MIC against each isolate increased. Mutations in the ompK36 porin gene evolved in 5 isolates. Among isolates with D179Y substitutions in KPC-3, bla(KPC-3) mutations reverted to wild type, were replaced by new mutations, or were retained. Carbapenem treatment of ceftazidime-avibactam-resistant K. pneumoniae infections may select for carbapenem resistance.
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