Evidence map›Paper›PMID 39838141›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025

Evolution of ceftazidime/avibactam resistance and plasmid dynamics in OXA-48-producing Klebsiella spp. during long-term patient colonization.

Salud Rodríguez-Pallares, María Alejandra Mateo-Vargas, Manuel Antonio Rodríguez-Iglesias, Jorge Arca-Suárez, Fátima Galán-Sánchez

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Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Antimicrobial agents and chemotherapy · 2026
    Article
  4. Article
  5. JAC-antimicrobial resistance · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Salud Rodríguez-PallaresServicio de Microbiología and Instituto de Investigación Biomédica A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña, A Coruña, Spain. salud361@gmail.com.
María Alejandra Mateo-VargasUniversidad de Cádiz, Cádiz, Spain.
Manuel Antonio Rodríguez-IglesiasUniversidad de Cádiz, Cádiz, Spain.
Jorge Arca-SuárezServicio de Microbiología and Instituto de Investigación Biomédica A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña, A Coruña, Spain.
Fátima Galán-SánchezUGC Microbiología and Instituto de Investigación E Innovación Biomédica de Cádiz (INIBICA), Hospital Universitario Puerta del Mar, Cádiz, Spain.

Funding

Axencia Galega de Innovación (GAIN), Consellería de Innovación, Consellería de Emprego e Industria IN607D2024/008Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CB21/13/00055Instituto de Salud Carlos III CM23/00104Instituto de Salud Carlos III JR21/00026Pfizer ID#69703059
6 · The paper itself

Abstract

purposeTo prospectively monitor the evolution of the resistome of OXA-48-producing Klebsiella species in a patient with long-term colonization, with a particular focus into the plasmid dynamics and the evolution of ceftazidime/avibactam resistance.

methodsAll OXA-48-producing Klebsiella spp. isolates from a single patient admitted to a hospital during seven months were prospectively collected. MICs were determined through reference broth microdilution. Multilocus sequence types, SNPs analysis, resistance mechanisms, genetic context of β-lactamases and plasmid dynamics were determined by WGS and bioinformatic analysis. The impact of β-lactamase variant obtained after ceftazidime/avibactam exposure was determined via cloning experiments.

resultsFour isolates, two before (one OXA-48-producing K. pneumoniae and one CTX-M-15-like-producing K. pneumoniae) and two after treatment with ceftazidime/avibactam (one OXA-48- and CTX-M-15-like-producing K. pneumoniae and one OXA-48- and CTX-M-15-like-producing K. aerogenes) were collected. The plasmid dynamics analysis demonstrated that the IncL and IncFIIK plasmids, in which bla

conclusionThe transfer of plasmid-borne β-lactamase resistance genes between intra- and interspecies bacterial populations enables the rapid diversification of the bacterial genome. The emergence of ceftazidime/avibactam resistance through the modification of CTX-M-enzymes represents a mechanism by which OXA-48-producing Enterobacterales may evolve toward ceftazidime/avibactam resistance in vivo.

Indexed as

Anti-Bacterial AgentsAzabicyclo Compoundsbeta-LactamasesCeftazidimeKlebsiellaKlebsiella InfectionsPlasmidsDrug CombinationsDrug Resistance, Multiple, BacterialHumansMicrobial Sensitivity TestsMultilocus Sequence TypingProspective StudiesAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo Compoundsbeta-LactamasesCeftazidimeDrug CombinationsoxacillinaseAntimicrobial resistanceCeftazidime/avibactamCTX-M-15EvolutionKlebsiella spp.OXA-48Plasmid dynamicsβ-lactamase

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.