Antibiotics (May 2021)

Epidemiology of Meropenem/Vaborbactam Resistance in KPC-Producing <i>Klebsiella pneumoniae</i> Causing Bloodstream Infections in Northern Italy, 2018

  • Paolo Gaibani,
  • Donatella Lombardo,
  • Linda Bussini,
  • Federica Bovo,
  • Beatrice Munari,
  • Maddalena Giannella,
  • Michele Bartoletti,
  • Pierluigi Viale,
  • Tiziana Lazzarotto,
  • Simone Ambretti

DOI
https://doi.org/10.3390/antibiotics10050536
Journal volume & issue
Vol. 10, no. 5
p. 536

Abstract

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Meropenem/Vaborbactam (MEM-VAB) is a novel carbapenem- β-lactamase inhibitor active against KPC-producing Enterobacteria. Herein, we evaluate the incidence of meropenem/vaborbactam-resistance among KPC-producing K. pneumoniae (KPC-Kp) bloodstream infection in a large Italian hospital. Meropenem/vaborbactam-resistance was found in 8% (n = 5) KPC-Kp, while 5% (n = 3) strains exhibited cross-resistance to ceftazidime/avibactam (CAZ-AVI). Genomic analysis revealed that meropenem/vaborbactam-resistance was associated with truncated OmpK35 and insertion of glycine and aspartic acid within OmpK36 at position 134–135 (GD134–135). Notably, no specific mutation was associated to cross-resistance. No specific antimicrobial treatment was related to favorable clinical outcomes, while cross-resistance was not associated to higher clinical and/or microbiological failures. Our study indicated that resistance to meropenem/vaborbactam was due to porins mutations and is associated with reduced susceptibility to both ceftazidime/avibactam and carbapenems.

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