Emergence of Ceftazidime-Avibactam Resistance and Restoration of Carbapenem Susceptibility in Klebsiella pneumoniae Carbapenemase-Producing K pneumoniae: A Case Report and Review of Literature

Author:

Shields Ryan K.12,Nguyen M. Hong12,Press Ellen G.1,Chen Liang3,Kreiswirth Barry N.3,Clancy Cornelius J.124

Affiliation:

1. Department of Medicine, University of Pittsburgh, Pennsylvania

2. XDR Pathogen Laboratory, University of Pittsburgh Medical Center, Pennsylvania

3. Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark;and

4. VA Pittsburgh Healthcare System, Pennsylvania

Abstract

Abstract We used meropenem to successfully treat a patient with bacteremia due to ceftazidime-avibactam-resistant, meropenem- susceptible Klebsiella pneumoniae that carried mutant blaKPC-3. Meropenem was bactericidal against ceftazidime-avibactam- resistant K pneumoniae isolates in vitro. Nevertheless, the role of carbapenems in treating such infections remains uncertain, because meropenem resistance is selected readily during passage experiments.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

Reference10 articles.

1. Emergence of ceftazidime-avibactam resistance due to plasmid-borne blaKPC-3 mutations during treatment of carbapenem-resistant Klebsiella pneumoniae infections;Shields;Antimicrob Agents Chemother,2017

2. Comparison of the pharmacodynamics of meropenem in patients with ventilator-associated pneumonia following administration by 3-hour infusion or bolus injection;Jaruratanasirikul;Antimicrob Agents Chemother,2005

3. Clinical outcomes, drug toxicity, and emergence of ceftazidime-avibactam resistance among patients treated for carbapenem-resistant Enterobacteriaceae infections;Shields;Clin Infect Dis,2016

4. Ceftazidime-avibactam as salvage therapy for infections caused by carbapenem-resistant organisms;Temkin;Antimicrob Agents Chemother,2017

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