Patient-to-Patient Transmission of Klebsiella pneumoniae Carbapenemase Variants with Reduced Ceftazidime-Avibactam Susceptibility

被引：20
|
作者：
Munoz-Price, L. Silvia [1 ]
Reeme, Allison E. [2 ]
Buchan, Blake W. [3 ]
Mettus, Roberta T. [4 ]
Mustapha, Mustapha M. [4 ,5 ]
Van Tyne, Daria [4 ,5 ]
Shields, Ryan K. [4 ,5 ]
Doi, Yohei [4 ,5 ,6 ,7 ]
机构：
[1] Med Coll Wisconsin, Dept Med, Div Infect Dis, Milwaukee, WI 53226 USA
[2] Froedtert Mem Lutheran Hosp, Dept Infect Prevent & Control, Milwaukee, WI USA
[3] Med Coll Wisconsin, Dept Pathol, Milwaukee, WI 53226 USA
[4] Univ Pittsburgh, Sch Med, Div Infect Dis, Pittsburgh, PA 15213 USA
[5] Univ Pittsburgh, Ctr Innovat Antimicrobial Therapy, Sch Med, Pittsburgh, PA 15213 USA
[6] Fujita Hlth Univ, Dept Microbiol, Toyoake, Aichi, Japan
[7] Fujita Hlth Univ, Dept Infect Dis, Toyoake, Aichi, Japan
来源：
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY | 2019年 / 63卷 / 10期
基金：
美国国家卫生研究院;
关键词：
Enterobacter cloacae complex; avibactam; omega loop;
D O I：
10.1128/AAC.00955-19
中图分类号：
Q93 [微生物学];
学科分类号：
071005 ; 100705 ;
摘要：
We report patient-to-patient transmission of Enterobacter hormaechei isolates with reduced susceptibility to ceftazidime-avibactam due to production of KPC-40, a variant of KPC-3 with a two-amino-acid insertion in the fl-loop region (L167_E168dup). The index patient had received a prolonged course of ceftazidime-avibactam therapy, whereas the second patient had not received the agent and still became colonized with the KPC-40-producing strain. The complex dynamics of KPC (Klebsiella pneumoniae carbapenemase) described here highlight several key diagnostic and therapeutic considerations.
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页数：4
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