A Ceftazidime-Avibactam-Resistant and Carbapenem-Susceptible Klebsiella pneumoniae Strain Harboring <i>bla</i> _KPC-14 Isolated in New York City

Abstract

Ceftazidime-avibactam is a potent antibiotic combination against <i>Klebsiella pneumoniae</i> carbapenemase (KPC)-producing <i>Enterobacteriaceae</i> Here, we describe a unique ceftazidime-avibactam-resistant and carbapenem-susceptible <i>K. pneumoniae</i> strain harboring a novel <i>bla</i>_KPC-14 variant. This strain was isolated from a New York City patient in 2003, which predates the introduction of avibactam. Despite resistance to ceftazidime-avibactam, the strain was susceptible to imipenem-relebactam and meropenem-vaborbactam. Comprehensive genomic sequencing revealed that <i>bla</i>_KPC-14 is harbored on an ST6 IncN plasmid associated with the early spread of <i>bla</i>_KPC<b>IMPORTANCE</b> KPC is currently the most common carbapenemase identified in the United States. More than 40 KPC variants have been described, of which KPC-2 and KPC-3 are the most frequent clinical variants. However, our understanding of the genetic structures and β-lactam resistance profiles of other novel KPC variants remains incomplete. Here, we report a novel <i>bla</i>_KPC variant (<i>bla</i>_KPC-14) and the complete genome sequence of <i>bla</i>_KPC-14-harboring <i>K. pneumoniae</i> strain BK13048, which is susceptible to carbapenems but resistant to ceftazidime-avibactam. To the best of our knowledge, this is one of the earliest KPC-producing <i>K. pneumoniae</i> strains exhibiting resistance to ceftazidime-avibactam.