Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018
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 hospi...
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MDPI AG
2021-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/5/536 |
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| author | Paolo Gaibani Donatella Lombardo Linda Bussini Federica Bovo Beatrice Munari Maddalena Giannella Michele Bartoletti Pierluigi Viale Tiziana Lazzarotto Simone Ambretti |
| author_facet | Paolo Gaibani Donatella Lombardo Linda Bussini Federica Bovo Beatrice Munari Maddalena Giannella Michele Bartoletti Pierluigi Viale Tiziana Lazzarotto Simone Ambretti |
| author_sort | Paolo Gaibani |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T11:40:39Z |
| format | Article |
| id | doaj.art-aa12c1a66bbb488c853b2eb06eb02ed4 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T11:40:39Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-aa12c1a66bbb488c853b2eb06eb02ed42023-11-21T18:32:04ZengMDPI AGAntibiotics2079-63822021-05-0110553610.3390/antibiotics10050536Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018Paolo Gaibani0Donatella Lombardo1Linda Bussini2Federica Bovo3Beatrice Munari4Maddalena Giannella5Michele Bartoletti6Pierluigi Viale7Tiziana Lazzarotto8Simone Ambretti9Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Infectious Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Infectious Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Infectious Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Infectious Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyOperative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyMeropenem/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.https://www.mdpi.com/2079-6382/10/5/536critically ill patientsporinscombination treatmentcross-resistance |
| spellingShingle | Paolo Gaibani Donatella Lombardo Linda Bussini Federica Bovo Beatrice Munari Maddalena Giannella Michele Bartoletti Pierluigi Viale Tiziana Lazzarotto Simone Ambretti Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018 Antibiotics critically ill patients porins combination treatment cross-resistance |
| title | Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018 |
| title_full | Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018 |
| title_fullStr | Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018 |
| title_full_unstemmed | Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018 |
| title_short | Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018 |
| title_sort | epidemiology of meropenem vaborbactam resistance in kpc producing i klebsiella pneumoniae i causing bloodstream infections in northern italy 2018 |
| topic | critically ill patients porins combination treatment cross-resistance |
| url | https://www.mdpi.com/2079-6382/10/5/536 |
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