Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Infection Prevention and Control, Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin, USA.
Antimicrob Agents Chemother. 2019 Sep 23;63(10). doi: 10.1128/AAC.00955-19. Print 2019 Oct.
We report patient-to-patient transmission of isolates with reduced susceptibility to ceftazidime-avibactam due to production of KPC-40, a variant of KPC-3 with a two-amino-acid insertion in the Ω-loop region (L167_E168dup). The index patient had received a prolonged course of ceftazidime-avibactam therapy, whereas the second patient had not received the agent and still became colonized with the KPC-40-producing strain. The complex dynamics of KPC ( carbapenemase) described here highlight several key diagnostic and therapeutic considerations.
我们报告了 1 例因产生 KPC-40（KPC-3 的一种变体，在 Ω 环区有两个氨基酸插入（L167_E168dup））而对头孢他啶-阿维巴坦的敏感性降低的 分离株的患者间传播。该指数患者接受了长期的头孢他啶-阿维巴坦治疗，而第二位患者没有接受该药物，但仍被产生 KPC-40 的菌株定植。这里描述的复杂的 KPC（碳青霉烯酶）动力学突出了几个关键的诊断和治疗考虑因素。
