Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia.
Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Microbiol Spectr. 2024 Jun 4;12(6):e0410523. doi: 10.1128/spectrum.04105-23. Epub 2024 May 3.
Resistance to ceftazidime-avibactam (CZA) due to carbapenemase (KPC) variants is increasing worldwide. We characterized two CZA-resistant clinical strains by antimicrobial susceptibility test, conjugation assays, and WGS. Isolates belonged to ST258 and ST45, and produced a KPC-31 and a novel variant KPC-197, respectively. The novel KPC variant presents a deletion of two amino acids on the Ω-loop (del_168-169_EL) and an insertion of two amino acids in position 274 (Ins_274_DS). Continued surveillance of KPC variants conferring CZA resistance in Colombia is warranted.
Latin America and the Caribbean is an endemic region for carbapenemases. Increasingly high rates of carbapenemase (KPC) have established ceftazidime-avibactam (CZA) as an essential antimicrobial for the treatment of infections due to MDR Gram-negative pathogens. Although other countries in the region have reported the emergence of CZA-resistant KPC variants, this is the first description of such enzymes in Colombia. This finding warrants active surveillance, as dissemination of these variants could have devastating public health consequences.
由于碳青霉烯酶（KPC）变体，对头孢他啶-阿维巴坦（CZA）的耐药性在全球范围内正在增加。我们通过抗菌药物敏感性试验、接合试验和 WGS 对两株 CZA 耐药的临床分离株进行了特征描述。分离株分别属于 ST258 和 ST45，分别产生了 KPC-31 和一种新型的 KPC-197 变体。新型 KPC 变体在 Ω-环上缺失了两个氨基酸（del_168-169_EL），并在 274 位插入了两个氨基酸（Ins_274_DS）。在哥伦比亚，需要继续监测导致 CZA 耐药的 KPC 变体。
拉丁美洲和加勒比地区是碳青霉烯酶的流行地区。碳青霉烯酶（KPC）的高发生率已使头孢他啶-阿维巴坦（CZA）成为治疗耐多药革兰氏阴性病原体感染的重要抗菌药物。尽管该地区的其他国家已经报告了 CZA 耐药的 KPC 变体的出现，但这是哥伦比亚首次描述此类酶。这一发现需要进行积极的监测，因为这些变体的传播可能会对公共卫生造成严重后果。
