Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018.
Abstract
In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.
Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland.Kuopio University Hospital, Unit of Infections and Hospital hygiene, Kuopio University Hospital, Kuopio, Finland.Eastern Finland laboratory Centre, Kuopio, Finland.Aalto University, Department of Computer Science, Espoo, Finland.Department of Biostatistics, University of Oslo, Oslo, Norway. Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland.Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland.Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland. MeSH
Anti-Bacterial AgentsAzabicyclo CompoundsBacterial ProteinsCeftazidimeDrug CombinationsDrug Resistance, BacterialHumansKlebsiella InfectionsKlebsiella pneumoniaeMicrobial Sensitivity TestsTreatment OutcomeTrimethoprim, Sulfamethoxazole Drug Combinationbeta-Lactamase Inhibitors
Pub Type(s)
Case Reports
Journal Article