Abstract
The objective was to study ceftazidime-avibactam resistant and susceptible Klebsiella pneumoniae isolated from a patient admitted to the Policlinico Umberto I of Rome for SARS-CoV2. Data on the evolution of patient’s conditions, antimicrobial therapies, and microbiological data were collected. Whole-genome sequencing performed by Illumina and Nanopore sequencing methods were used to type the strains. During the hospitalization, a SARS-CoV2-infected patient was colonized by a KPC-producing K. pneumoniae strain and empirically treated with ceftazidime-avibactam (CZA) when presenting spiking fever symptoms. Successively, ST2502 CZA-resistant strain producing the KPC-31 variant gave a pulmonary infection to the patient. The infection was treated with high doses of meropenem. The KPC-31-producing strain disappeared but the patient remained colonized by a KPC-3-producing K. pneumoniae strain. An interplay between highly conserved KPC-31- and KPC-3-producing ST2502 strains occurred in the SARS-CoV2 patient during the hospitalization, selected by CZA and carbapenem treatments, respectively.
Keywords: Ceftazidime-avibactam; KPC; Klebsiella pneumoniae.
【저자키워드】 Klebsiella pneumoniae., KPC, Ceftazidime-avibactam, 【초록키워드】 whole-genome sequencing, Evolution, High dose, SARS-CoV2, Hospitalization, Nanopore, Sequencing, variant, Infection, Symptoms, Fever, Patient, nanopore sequencing, Illumina, Strains, Therapies, Pulmonary infection, strain, Klebsiella pneumoniae, Ceftazidime, carbapenem, meropenem, Rome, pneumoniae, susceptible, avibactam, selected, performed, collected, occurred, conserved, the patient, remained, treated, were used, producing, presenting, conditions, Umberto, 【제목키워드】 Treatment, Case report, dosage, producing,