ArticleBMC infectious diseases2026
Targeting carbapenem-resistant and hypervirulent Klebsiella pneumoniae: in vitro evaluation of cefepime/zidebactam, aztreonam/avibactam, imipenem/relebactam, and meropenem/vaborbactam.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) is a growing concern because of the high mortality rates and limited treatment options. Few reports have examined the in vitro antibacterial activity of novel β-lactam/β-lactamase inhibitor drugs against CR-hvKp.
aimsThis study investigated the in vitro activity of β-lactam/β-lactamase inhibitor including cefepime/zidebactam, aztreonam/avibactam, imipenem/relabactam and meropenem/vaborbactam toward CR-hvKP isolates. Molecular epidemiological characterization of CR-hvKP strains was performed.
methodsA total of 106 non-repetitive clinical CR-hvKP strains were collected from patients at Sichuan Provincial People's Hospital between August 2018 and December 2023. A VITEK-2 compact system (bioMérieux, France) was used for the preliminary identification of strains and drug susceptibility testing, and matrix-assisted laser desorption/ionization mass spectrometry (Ci-phergen Biosystem, USA) was used to confirm the identity of all strains. CR-hvKP strains were screened using string tests and polymerase chain reaction. The E-test strip method was used to evaluate the in vitro antibacterial activity of novel antimicrobial drugs toward CR-hvKP stains. Molecular characterization of CR-hvKP strains was carried out using polymerase chain reaction amplification of resistance genes, virulence genes, housekeeping genes, and wzi genes. The virulence features of CR-hvKP strains were investigated using the Galleria mellonella infection model.
resultsThe susceptibility rates of CR-hvKP to cefepime/zidebactam and aztreonam/avibactam all exceeded 90%, with rates of 98.1% and 99.1%, respectively. CR-hvKP exhibited susceptibility rates of 57.5% and 65.1% to imipenem/relebactam and meropenem/vaborbactam, respectively. Sequencing identified ST11-KL64 as the predominant type in CR-hvKP strains. We identified three new ST subtypes, ST8115, ST8116 and ST8117. The most prevalent carbapenemase genes were bla
conclusionsCefepime/zidebactam and aztreonam/avibactam hold great promise for the treatment of CR-hvKP infections. Our findings will not only effectively address the challenge of CR-hvKP resistance, but also provide evidence to support the optimization of clinical therapeutic strategies and further promote the development and application of novel antimicrobial drugs.
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