In Vitro Selection of Meropenem Resistance among Ceftazidime-Avibactam-Resistant, Meropenem-Susceptible Klebsiella pneumoniae Isolates with Variant KPC-3 Carbapenemases

被引：85

作者：

Shields, Ryan K. ^{[1
,2
]}

Nguyen, M. Hong ^{[1
,2
]}

Press, Ellen G. ^{[1
]}

Chen, Liang ^{[3
]}

Kreiswirth, Barry N. ^{[3
]}

Clancy, Cornelius J. ^{[1
,2
,4
]}

机构：

[1] Univ Pittsburgh, Dept Med, 930 Scaife Hall, Pittsburgh, PA 15260 USA

[2] Univ Pittsburgh, Med Ctr, XDR Pathogen Lab, Pittsburgh, PA 15260 USA

[3] Rutgers State Univ, Publ Hlth Res Inst, New Jersey Med Sch, TB Ctr, Newark, NJ USA

[4] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA

来源：

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY | 2017年 / 61卷 / 05期

基金：

美国国家卫生研究院;

关键词：

carbapenem-resistant Enterobacteriaceae; Klebsiella pneumoniae carbapenemase; ceftazidime-avibactam resistance; sequence type 258 Klebsiella pneumoniae; KPC mutations; SEQUENCE TYPE 258; BETA-LACTAMASES; DORIPENEM; COLISTIN; STRAINS; ENTEROBACTERIACEAE; MUTATIONS; RESPONSES; GENOTYPES;

D O I：

10.1128/AAC.00079-17

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

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.

引用

页数：5

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