Evidence map›Paper›PMID 42106608›Full record

ArticleBMC genomic data2026

Genomic and molecular characterisation of a KPC-producing Klebsiella pneumoniae clinical isolate resistant to meropenem-vaborbactam, imipenem-relebactam, and ceftazidime-avibactam.

Yu Wan, Joshua L C Wong, Julia Sanchez-Garrido, Wen Wen Low, Jane F Turton, Fabio Morecchiato, Ilaria Baccani, Kirsty Dodgson, Gian Maria Rossolini, Neil Woodford and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC genomic data, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Yu WanAMR & HCAI Division, UK Health Security Agency, London, UK.
Joshua L C WongDepartment of Life Sciences, Imperial College London, London, UK.
Julia Sanchez-GarridoDepartment of Life Sciences, Imperial College London, London, UK.
Wen Wen LowDepartment of Life Sciences, Imperial College London, London, UK.
Jane F TurtonAMR & HCAI Division, UK Health Security Agency, London, UK.
Fabio MorecchiatoDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Ilaria BaccaniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Kirsty DodgsonDepartment of Medical Microbiology, Manchester University NHS Foundation Trust, Manchester, UK.
Gian Maria RossoliniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Neil WoodfordPublic Health Microbiology Reference Microbiology Division, UK Health Security Agency, London, UK.
Gad FrankelDepartment of Life Sciences, Imperial College London, London, UK.
Elita JauneikaiteNIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK.
Danièle MeunierAMR & HCAI Division, UK Health Security Agency, London, UK.
Katie L HopkinsAMR & HCAI Division, UK Health Security Agency, London, UK. katie.hopkins@ukhsa.gov.uk.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundResistance to carbapenems and third-generation cephalosporins is increasing in Klebsiella pneumoniae globally, restricting therapeutic options. The β-lactam/β-lactamase inhibitor combinations are widely used to circumvent β-lactamase-mediated resistance. In 2021, an unusual K. pneumoniae clinical isolate, KpMVR1, was recovered from a hospitalised patient in England, exhibiting resistance to meropenem-vaborbactam, imipenem-relebactam, and ceftazidime-avibactam. To investigate this phenomenon, we characterised the genome and antimicrobial susceptibility of KpMVR1 alongside two clonally related isolates susceptible to all three β-lactam/β-lactamase inhibitor combinations: KpMVS1, collected from the same patient 42 days earlier, and KpMVS2, from another patient in the same hospital.

methodsIllumina and MinION whole-genome sequencing were conducted for these three isolates, followed by hybrid genome assembly. Annotated genome assemblies were compared to identify genetic variation. Mutagenesis experiments were performed to verify predicted functional alterations.

resultsAll isolates belonged to clone ST8134 and carried bla

conclusionsKpMVR1 carried multiple resistance-associated genetic alterations and likely developed its resistance profile through within-patient evolution. This study highlights the importance of routine screening for resistant pathogens in vulnerable patients to guide antimicrobial chemotherapy and the need to characterise underlying resistance mechanisms to assess the risk of onward dissemination.

Indexed as

beta-LactamasesDrug Resistance, Multiple, BacterialKlebsiella pneumoniaeAnti-Bacterial AgentsAzabicyclo CompoundsBacterial Proteinsbeta-Lactamase InhibitorsBoronic AcidsCeftazidimeDrug CombinationsGenome, BacterialHeterocyclic Compounds, 1-RingHumansImipenemKlebsiella InfectionsMeropenemAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsBacterial Proteinsbeta-Lactamase Inhibitorsbeta-LactamasesBoronic AcidsCeftazidimeDrug CombinationsHeterocyclic Compounds, 1-RingImipenemMeropenemmeropenem and vaborbactamrelebactamAntimicrobial resistanceCarbapenem resistanceComparative genomicsHybrid genome assemblyInsertion sequencesKlebsiella pneumoniaeKPC-157Mutagenesis experimentsOmpK36β-Lactamase inhibitors

Identifiers

PMID42106608
PMCPMC13182041

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.