Resistance to Ceftazidime/Avibactam Plus Meropenem/Vaborbactam When Both Are Used Together Is Achieved in Four Steps in Metallo-β-Lactamase-Negative Klebsiella Pneumoniae

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 2020 Jul 15

PMID 32660988

Citations 11

Authors

Punyawee Dulyayangkul

Edward J A Douglas

Filip Lastovka

Matthew B Avison

Affiliations

Soon will be listed here.

Abstract

Serine β-lactamases are dominant causes of β-lactam resistance in isolates. Recently, this has driven clinical deployment of the β-lactam-β-lactamase inhibitor pairs ceftazidime/avibactam and meropenem/vaborbactam. We show that four steps, i.e., and mutation plus carriage of OXA-232 and KPC-3-D178Y variant β-lactamases, confer ceftazidime/avibactam and meropenem/vaborbactam resistance when both pairs are used together. These findings have implications for decision making about sequential and combinatorial use of these β-lactam-β-lactamase inhibitor pairs to treat infections.

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