Abstract
From September to October 2019, seven patients colonised or infected with a ceftazidime-avibactam (CZA)-resistant Klebsiella pneumoniae carbapenemase (KPC)-2-producing K. pneumoniae were detected in two intensive care units of a Greek general hospital. The outbreak strain was sequence type (ST)147 and co-produced KPC-2 and the novel plasmid-borne Vietnamese extended-spectrum β-lactamase (VEB)-25 harbouring a K234R substitution associated with CZA resistance. Epidemiological investigations revealed that the resistance was probably acquired by horizontal transmission independently from previous CZA exposure.
Keywords:
K.pneumoniae; K234R; KPC-2; VEB-14; VEB-25; ceftazidime-avibactam.
MeSH terms
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Aged
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Aged, 80 and over
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Anti-Bacterial Agents / pharmacology*
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Azabicyclo Compounds
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Ceftazidime
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Disease Outbreaks
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Drug Combinations
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Drug Resistance, Bacterial
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Female
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Genome, Bacterial
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Greece
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Humans
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Intensive Care Units
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Klebsiella Infections / microbiology*
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Klebsiella pneumoniae / drug effects
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Klebsiella pneumoniae / enzymology
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Klebsiella pneumoniae / genetics*
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Klebsiella pneumoniae / isolation & purification
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Male
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Microbial Sensitivity Tests
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Middle Aged
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Mutation / genetics
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Whole Genome Sequencing
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beta-Lactamases / genetics*
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beta-Lactamases / metabolism*
Substances
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Anti-Bacterial Agents
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Azabicyclo Compounds
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Drug Combinations
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avibactam, ceftazidime drug combination
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Ceftazidime
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beta-Lactamases