Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018

• Main Authors: Paolo Gaibani (Author), Donatella Lombardo (Author), Linda Bussini (Author), Federica Bovo (Author), Beatrice Munari (Author), Maddalena Giannella (Author), Michele Bartoletti (Author), Pierluigi Viale (Author), Tiziana Lazzarotto (Author), Simone Ambretti (Author)
• Format: Book
• Published: MDPI AG, 2021-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Meropenem/Vaborbactam (MEM-VAB) is a novel carbapenem- β-lactamase inhibitor active against KPC-producing Enterobacteria. Herein, we evaluate the incidence of meropenem/vaborbactam-resistance among KPC-producing <i>K. pneumoniae</i> (KPC-Kp) bloodstream infection in a large Italian hospital. Meropenem/vaborbactam-resistance was found in 8% (<i>n</i> = 5) KPC-Kp, while 5% (<i>n</i> = 3) strains exhibited cross-resistance to ceftazidime/avibactam (CAZ-AVI). Genomic analysis revealed that meropenem/vaborbactam-resistance was associated with truncated OmpK35 and insertion of glycine and aspartic acid within OmpK36 at position 134-135 (GD134-135). Notably, no specific mutation was associated to cross-resistance. No specific antimicrobial treatment was related to favorable clinical outcomes, while cross-resistance was not associated to higher clinical and/or microbiological failures. Our study indicated that resistance to meropenem/vaborbactam was due to porins mutations and is associated with reduced susceptibility to both ceftazidime/avibactam and carbapenems.

Item Description

10.3390/antibiotics10050536
2079-6382