ArticleBMC microbiology2026
Fitness cost of ceftazidime-avibactam resistance acquisition in carbapenem-resistant hypervirulent Klebsiella pneumoniae.
Article in BMC microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Repeated insertions at positions 261-280 in KPC-2 highlight a ceftazidime-avibactam resistance hotspot.iScience · 2026Article
- Antimicrobial Resistance, Molecular Epidemiology, and Virulence Profiles of Hypervirulent Carbapenem-ResistantInfection and drug resistance · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundAntibiotic-resistant Klebsiella pneumoniae (KP) poses a serious global public health threat. However, research on the resistance mechanisms and accompanying phenotypic changes in carbapenem-resistant hypervirulent KP (CR-hvKP) under antibiotic treatment remains limited. This study aims to investigate the resistance mechanisms of CR-hvKP to ceftazidime-avibactam (CAZ-AVI) and its concomitant phenotypic shifts, employing an in vitro induction assay.
methodsSix ceftazidime-avibactam (CAZ-AVI)-susceptible CR-hvKP clinical isolates were subjected to in-vitro resistance induction. We used pulsed-field gel electrophoresis, whole-genome sequencing, biofilm formation, a Galleria mellonella infection model, and in-vitro competitive growth assays to characterize the virulence and adaptive changes of the isolates.
resultsCAZ-AVI-resistant CR-hvKP demonstrated enhanced biofilm formation capacity, but the G. mellonella infection model indicated a decrease in virulence of the drug-resistant strain. While resistant strains exhibited diminished competitive fitness in vitro, growth curves did not differ significantly. Genomic characterization identified both resistant and susceptible isolates as ST11, with resistant isolates exhibiting an expanded resistance gene profile, primarily involving KPC-2 variants. All strains carried typical virulence determinants, including iroE (a glycosidase gene within the salmochelin siderophore system), iucABCD (the aerobactin biosynthesis operon), and iutA (the gene encoding the outer membrane receptor for ferric-aerobactin).
conclusionsCAZ-AVI resistance acquisition in CR-hvKP primarily occurs through KPC-2 mutations. Strains harboring such mutations exhibit enhanced biofilm formation capacity but attenuated virulence and competitiveness. Research into these adaptive changes will facilitate the development of improved clinical strategies for the treatment and control of carbapenem-resistant hypervirulent Klebsiella pneumoniae.
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