Emergence of KPC-8-producing K. pneumoniae infection without prior exposure to ceftazidime/avibactam: the threat of de novo infections by ceftazidime/avibactam-resistant KPC variants

Mateo-Vargas, María AlejandraRodríguez-Pallares, SaludArca-Suárez, JorgeLópez Cerero, LorenaRodríguez-Iglesias, ManuelGalán-Sánchez, Fátima2025-11-172025-11-172025-04-22Mateo-Vargas, M.A., Rodríguez-Pallares, S., Arca-Suárez, J., López Cerero, L., Rodríguez-Iglesias, M. y Galán-Sánchez, F. (2025). Emergence of KPC-8-producing K. pneumoniae infection without prior exposure to ceftazidime/avibactam: the threat of de novo infections by ceftazidime/avibactam-resistant KPC variants. Antimicrobial Agents and Chemotherapy, 69 (6), 69:e01494-24.https://doi.org/10.1128/aac.01494-24.0066-48041098-6596https://hdl.handle.net/11441/179055De novo infections caused by ceftazidime/avibactam-resistant KPC variants are rarely reported. We characterize the evolution of a KPC-8-producing Klebsiella pneumoniae strain involved in a primary infection without previous ceftazidime/avibactam treatment. During a 15-month follow-up, changes in carbapenem susceptibility due to porin alterations were observed, remaining susceptible to meropenem/vaborbactam, imipenem/relebactam, and cefiderocol. High- and low-permeability recombinant Escherichia coli isolates analysis revealed that, unlike the widespread ceftazidime/avibactam-resistant variant KPC-31, KPC-8 confers ceftazidime/avibactam resistance without decreasing carbapenemase activity.application/pdf8 p.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/KPC-8Klebsiella pneumoniaeCeftazidime/avibactamKPC-31Meropenem/vaborbactamEvolutionImipenem/relebactamCefiderocolβ-lactamaseAntimicrobial resistanceEmergence of KPC-8-producing K. pneumoniae infection without prior exposure to ceftazidime/avibactam: the threat of de novo infections by ceftazidime/avibactam-resistant KPC variantsinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccesshttps://doi.org/10.1128/aac.01494-24