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

Abstract

In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing <i>Klebsiella pneumoniae</i> 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 bla_KPC-2-producing <i>K. pneumoniae</i> 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.