Ceftazidime/Avibactam-Resistant <i>Klebsiella pneumoniae</i> subsp. <i>pneumoniae</i> Isolates in a Tertiary Italian Hospital: Identification of a New Mutation of the Carbapenemase Type 3 (KPC-3) Gene Conferring Ceftazidime/Avibactam Resistance

Ceftazidime/Avibactam-Resistant <i>Klebsiella pneumoniae</i> subsp. <i>pneumoniae</i> Isolates in a Tertiary Italian Hospital: Identification of a New Mutation of the Carbapenemase Type 3 (KPC-3) Gene Conferring Ceftazidime/Avibactam Resistance

Several <i>Klebsiella pneumoniae</i> carpabenemase (KPC) gene mutations are associated with ceftazidime/avibactam (CAZ-AVI) resistance. Here, we describe four <i>Klebsiella pneumoniae</i> subsp. <i>pneumoniae</i> CAZ-AVI-resistant clinical isolates, collected at t...

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Autores principales: Carla Fontana, Marco Favaro, Laura Campogiani, Vincenzo Malagnino, Silvia Minelli, Maria Cristina Bossa, Anna Altieri, Massimo Andreoni, Loredana Sarmati
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
Materias:
ceftazidime/avibactam
multi-drug resistance
antibiotic resistance
beta-lactamase inhibitors resistance
Q168L substitution
Biology (General)
QH301-705.5
Acceso en línea:https://doaj.org/article/f2a28b6a5c4a4818af77015ad2982ba4
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Sumario:Several <i>Klebsiella pneumoniae</i> carpabenemase (KPC) gene mutations are associated with ceftazidime/avibactam (CAZ-AVI) resistance. Here, we describe four <i>Klebsiella pneumoniae</i> subsp. <i>pneumoniae</i> CAZ-AVI-resistant clinical isolates, collected at the University Hospital of Tor Vergata, Rome, Italy, from July 2019 to February 2020. These resistant strains were characterized as KPC-3, having the transition from cytosine to thymine (CAC-TAC) at nucleotide position 814, with histidine that replaces tyrosine (H272Y). In addition, two different types of KPC gene mutations were detected. The first one, common to three strains, was the D179Y (G532T), associated with CAZ-AVI resistance. The second mutation, found only in one strain, is a new mutation of the KPC-3 gene: a transversion from thymine to adenine (CTG-CAG) at nucleotide position 553. This mutation causes a KPC variant in which glutamine replaces leucine (Q168L). None of the isolates were detected by a rapid immunochromatographic assay for detection of carbapenemase (NG Biotech, Guipry, France) and were unable to grow on a selective chromogenic medium Carba SMART (bioMerieux, Firenze, Italy). Thus, they escaped common tests used for the prompt detection of <i>Klebsiella pneumoniae</i> KPC-producing.

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