在治疗期间，通过序列类型39的产KPC-2肺炎克雷伯菌中不同的基因组适应性变化出现了对头孢他啶-阿维巴坦的耐药性。
Emergence of ceftazidime-avibactam resistance through distinct genomic adaptations in KPC-2-producing Klebsiella pneumoniae of sequence type 39 during treatment.
作者信息
Galani Irene, Karaiskos Ilias, Angelidis Evdokia, Papoutsaki Vassiliki, Galani Lamprini, Souli Maria, Antoniadou Anastasia, Giamarellou Helen
机构信息
4th Department of Internal Medicine, Infectious Diseases Laboratory,Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
University General Hospital "ATTIKON", Rimini 1, 124 62, Chaidari, Greece.
出版信息
Eur J Clin Microbiol Infect Dis. 2021 Jan;40(1):219-224. doi: 10.1007/s10096-020-04000-9. Epub 2020 Jul 30.
Three ceftazidime-avibactam-resistant KPC-2-producing Klebsiella pneumoniae strains of ST39 were isolated in Greece, from rectal swabs of three patients after 10-15 days of treatment. The patients were treated with ceftazidime-avibactam as monotherapy or in combination with colistin. Two of these strains harbored a D179Y or a D179V substitution in the Ω loop of KPC-2, corresponding to KPC-33, or to the novel KPC-57, respectively. The third strain had a 15 amino acid insertion after position 259 in the KPC-2, corresponding to KPC-44.
在希腊，从3例患者治疗10 - 15天后的直肠拭子中分离出3株产KPC - 2的肺炎克雷伯菌，它们对头孢他啶 - 阿维巴坦耐药，属于ST39型。这些患者接受了头孢他啶 - 阿维巴坦单药治疗或与黏菌素联合治疗。其中2株菌株在KPC - 2的Ω环中有D179Y或D179V替代，分别对应于KPC - 33或新型KPC - 57。第三株菌株在KPC - 2的259位之后有15个氨基酸插入，对应于KPC - 44。
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