High-level cefiderocol and ceftazidime/avibactam resistance in KPC-producing Klebsiella pneumoniae associated with mutations in KPC and the sensor histidine kinase EnvZ

Jacqueline Findlay¹, Gabriele Bianco^{2

3}, Matteo Boattini^{3

4

5}, Patrice Nordmann^{1

6}

Affiliations

¹ Medical and Molecular Microbiology, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland.
² Department of Experimental Medicine, University of Salento, Via Provinciale Monteroni n. 165, Lecce 73100, Italy.
³ Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy.
⁴ Department of Public Health and Paediatrics, University of Torino, Turin, Italy.
⁵ Lisbon Academic Medical Centre, Lisbon, Portugal.
⁶ Swiss National Reference Center for Emerging Antibiotic Resistance (NARA), University of Fribourg, Fribourg, Switzerland.

Jacqueline Findlay et al. J Antimicrob Chemother. 2025.

. 2025 Apr 2;80(4):1155-1157.

doi: 10.1093/jac/dkaf048.

Jacqueline Findlay¹, Gabriele Bianco^{2

3}, Matteo Boattini^{3

4

5}, Patrice Nordmann^{1

6}

¹ Medical and Molecular Microbiology, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland.
² Department of Experimental Medicine, University of Salento, Via Provinciale Monteroni n. 165, Lecce 73100, Italy.
³ Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy.
⁴ Department of Public Health and Paediatrics, University of Torino, Turin, Italy.
⁵ Lisbon Academic Medical Centre, Lisbon, Portugal.
⁶ Swiss National Reference Center for Emerging Antibiotic Resistance (NARA), University of Fribourg, Fribourg, Switzerland.

No abstract available

References

1. Bush K, Bradford PA. Epidemiology of β-lactamase-producing pathogens. Clin Microbiol Rev 2020; 33: e00047-19. 10.1128/CMR.00047-19 - DOI - PMC - PubMed
1. Di Pilato V, Errico G, Monaco M et al. The changing epidemiology of carbapenemase-producing Klebsiella pneumoniae in Italy: toward polyclonal evolution with emergence of high-risk lineages. J Antimicrob Chemother 2021; 76: 355– 61. 10.1093/jac/dkaa431 - DOI - PubMed
1. Humphries RM, Yang S, Hemarajata P et al. First report of ceftazidime-avibactam resistance in a KPC-3-expressing Klebsiella pneumoniae isolate. Antimicrob Agents Chemother 2015; 59: 6605– 7. 10.1128/AAC.01165-15 - DOI - PMC - PubMed
1. Hobson CA, Pierrat G, Tenaillon O et al. Klebsiella pneumoniae carbapenemase variants resistant to ceftazidime-avibactam: an evolutionary overview. Antimicrob Agents Chemother 2022; 66: e0044722. 10.1128/aac.00447-22 - DOI - PMC - PubMed
1. Hobson CA, Cointe A, Jacquier H et al. Cross-resistance to cefiderocol and ceftazidime-avibactam in KPC β-lactamase mutants and the inoculum effect. Clin Microbiol Infect 2021; 27: 1172.e7– e10. 10.1016/j.cmi.2021.04.016 - DOI - PubMed