Ceftazidime-Avibactam Resistance Associated with Increased bla KPC-3 Gene Copy Number Mediated by pKpQIL Plasmid Derivatives in Sequence Type 258 Klebsiella pneumoniae

Author:

Coppi Marco1,Di Pilato Vincenzo1ORCID,Monaco Francesco2,Giani Tommaso1ORCID,Conaldi Pier Giulio23,Rossolini Gian Maria14

Affiliation:

1. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

2. Laboratory of Clinical Pathology, Microbiology, and Virology, IRCCS-ISMETT, Palermo, Italy

3. Department of Research, IRCCS-ISMETT, Palermo, Italy

4. Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy

Abstract

This study reports on the characterization of two ceftazidime-avibactam (CZA)-resistant KPC-producing Klebsiella pneumoniae strains (KP-14159 and KP-8788) sequentially isolated from infections occurred in a patient never treated with CZA. Whole-genome sequencing characterization using a combined short- and long-read sequencing approach showed that both isolates belonged to the same ST258 strain, had altered outer membrane porins (a truncated OmpK35 and an Asp137Thr138 duplication in the L3 loop of OmpK36), and carried novel pKpQIL plasmid derivatives (pIT-14159 and pIT-8788, respectively) harboring two copies of the Tn 4401a KPC-3-encoding transposon.

Funder

Ministero dell'Istruzione, dell'Università e della Ricerca

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

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