<i>In vivo</i> evolution to hypermucoviscosity and ceftazidime/avibactam resistance in a liver abscess caused by <i>Klebsiella pneumoniae</i> sequence type 512
Here we describe the evolution of KPC-3-producing ST512 <i>K. pneumoniae</i> isolated at three different times from the same patient of which the last one, from a biliary abscess, showed CZA resistance by KPC-31 production and manifested hmv colony phenotype. Hypervirulent <i>Klebsiella pneumoniae</i> (hv-Kp) isolates are increasingly reported worldwide. Their hypervirulent traits are associated with the presence of rmpA/A2 genes and an hmv. In this study, we identified an hmv-Kp that lacked the rmpA-D cluster but showed an amino acid substitution in the Wzc tyrosin kinase protein, involved in the capsular biosynthesis. This hmv-Kp strain emerged <i>in vivo</i> and evolved resistance to ceftazidime/avibactam resistance in a liver abscess of a patient. Our findings suggest that wzc mutations may be underreported, making it challenging to distinguish hv-Kp from "classic" <i>K. pneumoniae</i> with an hmv phenotype.
Authors
- Giammarco Raponi (ORCID: https://orcid.org/0000-0002-9665-0811)
- Paolo Villari (ORCID: https://orcid.org/0000-0002-3139-0668)
- Alessandra Carattoli (ORCID: https://orcid.org/0000-0002-6120-6526)
- Giancarlo Ceccarelli (ORCID: https://orcid.org/0000-0001-5921-3180)
- Cecilia Ambrosi (ORCID: https://orcid.org/0000-0003-2163-1613)
- Riccardo Polani (ORCID: https://orcid.org/0000-0001-8838-5598)
- Valerio Capitani
- Mariateresa Ceparano (ORCID: https://orcid.org/0000-0002-8304-365X)
- Anna Teresa Palamara (ORCID: https://orcid.org/0000-0001-8330-4381)
- Gabriele Arcari (ORCID: https://orcid.org/0000-0001-9629-4637)
- Daniela Scribano (ORCID: https://orcid.org/0000-0002-2901-265X)
- Carolina Marzuillo (ORCID: https://orcid.org/0000-0002-7299-5727)
- Alice De Francesco
Institutions
- Vita-Salute San Raffaele University (IT)
- Istituto Superiore di Sanità (IT)
- Policlinico Umberto I (IT)
- San Raffaele University of Rome (IT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Istituto Pasteur (IT)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- Sapienza University of Rome (IT)
Publication Details
- Journal
- mSphere
- Published
- 2024-08-22
- DOI
- https://doi.org/10.1128/msphere.00423-24
- Citations
- 9
- Primary Topic
- Antibiotic Resistance in Bacteria
- Type
- article
- Field-Weighted Citation Impact
- 1.53
Funders
- European Commission
- Ministero della Salute
- Ministero dell’Istruzione, dell’Università e della Ricerca
- Sapienza Università di Roma