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Case Reports
. 2019 May;24(19):1900256.
doi: 10.2807/1560-7917.ES.2019.24.19.1900256.

Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018

Kati Räisänen  1 , Irma Koivula  2 , Heikki Ilmavirta  3 , Santeri Puranen  4 , Teemu Kallonen  1   5 , Outi Lyytikäinen  1 , Jari Jalava  1
Affiliations
Case Reports

Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018

Kati Räisänen et al. Euro Surveill. 2019 May.

Abstract

In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.

Keywords: Klebsiella pneumoniae; carbapenem; ceftazidime-avibactam; resistance; whole-genome sequencing, KPC-2.

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Conflict of interest statement

Conflict of interest: None declared.

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