English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

The emergence and prevalence of carbapenem-resistant  Enterobacteriaceae  (CRE) have drawn worldwide attention. Ceftazidime/avibactam (CAZ/AVI) gives us a valuable alternative strategy to treat CRE infections. Unfortunately, CAZ/AVI resistance could occur during CAZ/AVI treatment. The CAZ/AVI-resistant Carbapenem-resistant  Klebsiella pneumoniae  (CR-KP) (KP137060) and earlier CAZ/AVI-susceptible isolate (KP135194) from the same hospitalized patient were collected at Fujian Medical University Union Hospital between October and November 2019. In this study, CAZ/AVI MICs of CAZ/AVI-susceptible and -resistant isolates (KP135194 and KP137060) were 4 mg/L and 128 mg/L, respectively; and the two isolates had the same antibiotic resistance pattern to other carbapenems. Two strains were then submitted for whole-genome sequencing and bioinformatic analysis.  ompK36  was not detected in two isolates. No mutation was observed in  bla   KPC-2 ,  ompK35  and  ompK37  in this study and there was no significant difference of the expression in  bla   KPC-2 ,  ompK35  and  ompK37  between the two isolates ( p >0.05). Two isolates were sequence type 11 and harbored  bla   KPC-2 ,  bla   SHV-182  and  bla   TEM-1B . Compared with KP135194, KP137060 harbored an additional  bla   NDM-5  positive plasmid.  bla   NDM-5  gene could be successfully transferred into  E. coli  J53 at a conjugation frequency of 1.14×10 -4 . Plasmid stability testing showed that  bla   KPC-2 - and  bla   NDM-5 -harboring plasmids were still stably maintained in the hosts. Growth assay and growth competition experiments showed there was no significant difference in fitness cost between two CR-KP isolates. Our study described the acquisition of a  bla   NDM-5 -harboring plasmid leading to resistance to ceftazidime/avibactam in KPC-2-producing  Klebsiella pneumoniae  during treatment. This phenomenon deserves further exploration.

frontiers in cellular and infection microbiology

Acquisition of a Stable and Transferable blaNDM-5-Positive Plasmid With Low Fitness Cost Leading to Ceftazidime/Avibactam Resistance in KPC-2-Producing Klebsiella pneumoniae During Treatment