Evidence map›Paper›PMID 40448249›Full record

ArticleAnnals of clinical microbiology and antimicrobials2025

Diverse modes of ceftazidime/avibactam resistance acquisition in carbapenem-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa from a Chinese intensive care unit.

Junxin Zhou, Minhua Chen, Min Liang, Xinhong Han, Rui Weng, Yue Li, Yan Jiang, Xiaoting Hua, Xiaoxing Du, Weiping Wang and 2 more

Abstract read
In one paragraph

Article in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

9 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Case report: rapid in vivo resistance mechanism shifts in multiple carbapenem-resistant Pseudomonas aeruginosa strains after esophagectomy in an immunocompromised patient: a case report.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  5. Review
  6. TheFrontiers in cellular and infection microbiology · 2026
    Article
  7. Article
  8. Article
  9. Study on resistance mechanisms and molecular epidemiology of carbapenem-resistantFrontiers in cellular and infection microbiology · 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

12 authors.

Junxin Zhou *Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Minhua Chen *Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Min LiangDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Xinhong HanDepartment of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.
Rui WengDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Yue LiDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Yan JiangDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Xiaoting HuaDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Xiaoxing DuDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China.
Weiping WangDepartment of Clinical Laboratory, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Zhihui ZhouDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China. zhouzhihui@zju.edu.cn.
Yunsong YuDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3, East Qingchun Rd, Shangcheng District, Hangzhou, 310016, China. yvys119@zju.edu.cn.

Funding

the National Key Research and Development Project of China No. 2023YFC2307100the National Natural Science Foundation of China No. 82272373the Zhejiang Provincial Natural Science Foundation of China No. LZY24H150003
6 · The paper itself

Abstract

objectivesTo investigate the mechanisms of ceftazidime/avibactam (CZA) resistance and the nosocomial dissemination of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) in an intensive care unit (ICU) in China.

methodsClinical CRPA and CRKP isolates were obtained from an ICU of a tertiary hospital in China from August 2020 to February 2021. Antimicrobial susceptibility was determined according to CLSI. WGS, cloning experiments and kinetic parameters were conducted to reveal resistance mechanisms, molecular characteristics and dissemination of CRPA and CRKP.

resultsWe isolated 32 CZA-resistant strains, including 12 CRPA and 20 CRKP strains from an ICU between August 2020 and February 2021. CZA resistance was associated with the presence of NDM and efflux pumps in CRKP strains, whereas bla

conclusionsIn CRKP and CRPA, diverse resistance mechanisms contributed to CZA resistance. These CZA-resistant strains were transmitted among patients in the ICU and even across regions to the other healthcare unit when the patient was transferred.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsCarbapenemsCeftazidimeDrug Resistance, Multiple, BacterialKlebsiella pneumoniaePseudomonas aeruginosaBacterial Proteinsbeta-LactamasesCarbapenem-Resistant EnterobacteriaceaeChinaDrug CombinationsHumansIntensive Care UnitsKlebsiella InfectionsMicrobial Sensitivity TestsAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsBacterial Proteinsbeta-LactamasesCarbapenemsCeftazidimeDrug CombinationsCeftazidime/avibactamCross-regional transmissionKlebsiella pneumoniaeKPCNon-Tn4401 elementsPseudomonas aeruginosa

Identifiers

PMID40448249
PMCPMC12125794

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Registered trials

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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.