Genomic analysis of ceftazidime/avibactam-resistant Klebsiella pneumoniae isolates from transplant unit
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Key Takeaway
Note genomic patterns in ceftazidime/avibactam-resistant K. pneumoniae isolates from transplant settings.
A retrospective cohort study analyzed 14 clinical isolates of ceftazidime/avibactam-resistant Klebsiella pneumoniae from the Mediterranean Institute for Transplants and Highly Specialized Therapies (ISMETT) in Palermo, Italy. This observational genomic characterization study examined isolates from a transplant unit setting, with no intervention, comparator, or clinical outcomes reported.
Most strains (exact proportion not reported) belonged to sequence type ST101 and carried blaKPC-31, blaKPC-3, or blaKPC-34 resistance genes, often with resistance-associated mutations. The analyzed strains revealed multidrug resistance patterns and frequent outer membrane protein alterations. Researchers also identified a significant spectrum of virulence genes and sequence type–specific plasmid replicons potentially involved in gene dissemination.
No safety, tolerability, or adverse event data were reported as this was an isolate analysis without patient-level information. The study has several limitations: small sample size (14 isolates), retrospective observational design, absence of clinical correlation data, and no information about patient outcomes, treatment, or infection control measures. Funding and conflicts of interest were not reported.
This genomic characterization provides descriptive data about resistance mechanisms in ceftazidime/avibactam-resistant Klebsiella pneumoniae from a transplant setting but offers no direct clinical practice guidance. The findings suggest concerning multidrug resistance patterns and virulence factors in this vulnerable population, warranting further investigation with clinical correlation studies.
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View Original Abstract ↓
IntroductionKlebsiella pneumoniae infections are a significant healthcare concern due to advancing antimicrobial resistance rates and virulence genes’ detection. Specifically, ceftazidime/avibactam resistance is increasingly diffused among K. pneumoniae clinical isolates, limiting therapeutic choices and complicating patients’ outcomes. Some authors documented the simultaneous presence of ceftazidime/avibactam resistance markers and specific virulence genes. According to these premises, we characterized ceftazidime/avibactam-resistant K. pneumoniae strains, exploring their diffusion at the Mediterranean Institute for Transplants and Highly Specialized Therapies (ISMETT) of Palermo, Italy.Materials and methodsA total of 14 ceftazidime/avibactam-resistant strains were retrospectively analyzed using whole-genome sequencing and Sanger validation.ResultsMost strains belonged to ST101 and carried blaKPC-31, blaKPC-3, or blaKPC-34 genes, often with resistance-associated mutations. The analysed strains revealed multidrug resistance, frequent outer membrane protein alterations, and a significant spectrum of virulence genes. Additionally, plasmid analysis revealed sequence type–specific replicons potentially involved in gene dissemination.DiscussionThese findings highlight a convergence of resistance and virulence traits in high-risk K. pneumoniae clones, enhancing the importance of MDR pathogens’ genomic surveillance in critical healthcare settings.
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