TABLE 1.
Characterization of the relevant antimicrobial sensitivity profiles of blaKPC-2 variantsa
| No. | Specimen date | Source | KPC variant | Nucleotide | Amino acid substitution | Other β-lactam genes | MIC (mg/L) |
Detection method |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ETP | IPM | MEM | CZA | MEV | mCIM | eCIM | APB/EDTA | NG-test Carba 5 | GeneXpert Carba-R | |||||||
| 1 | 2019/12 | UR | KPC-33 | G532T | D179Y | ND | 32 (R) | 0.5 (S) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 2 | 2020/05 | UR | KPC-33 | G532T | D179Y | ND | 16 (R) | 0.5 (S) | 1 (S) | 64 (R) | 2(S) | – | – | – | KPC+ | |
| 3 | 2020/10 | SF | KPC-33 | G532T | D179Y | blaLAP-2, blaSHV-12, blaTEM-1B | 32 (R) | 0.5 (S) | 2 (I) | >64 (R) | 1(S) | – | – | – | KPC+ | |
| 4 | 2020/09 | SP | KPC-33 | G532T | D179Y | ND | 16 (R) | 0.25 (S) | 1 (S) | 64 (R) | 1(S) | – | – | – | KPC+ | |
| 5 | 2020/09 | MB | KPC-33 | G532T | D179Y | ND | 16 (R) | 0.5 (S) | 2 (I) | >64 (R) | 1(S) | – | – | – | KPC+ | |
| 6 | 2020/09 | SF | KPC-35 | T503C | L169P | blaLAP-2, blaSHV-12, blaTEM-1B | 16 (R) | 1 (S) | 4 (R) | 64 (R) | 2(S) | – | – | KPC+ | KPC+ | |
| 7 | 2020/09 | SP | KPC-35 | T503C | L169P | blaLAP-2, blaSHV-12, blaTEM-1B | 8 (R) | 0.25 (S) | 1 (S) | 32 (R) | 0.5(S) | – | – | KPC+ | KPC+ | |
| 8 | 2020/09 | AB | KPC-35 | T503C | L169P | blaTEM-1B, blaSHV-12 | 0.125 (S) | 1 (S) | 1 (S) | 16 (R) | 0.03(S) | – | – | KPC+ | KPC+ | |
| 9 | 2021/03 | SP | KPC-71 | ACT insertion | 181S_182P insertion | blaLAP-2, blaSHV-12, blaTEM-1B, blaCTX-M-65 | 16 (R) | 0.5 (S) | 2 (I) | >64 (R) | 0.5(S) | – | – | – | KPC+ | |
| 10 | 2020/01 | UR | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 2 (I) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 11 | 2020/03 | SP | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 1 (S) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 12 | 2020/04 | AB | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 2 (I) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 13 | 2020/04 | UR | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 2 (I) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 14 | 2020/04 | SP | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 0.5 (S) | 1 (S) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 15 | 2020/01 | AB | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 1 (S) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 16 | 2019/10 | SP | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 2 (I) | 4 (R) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 17 | 2020/05 | SP | KPC-76 | G532T+TR insertion | D179Y+262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 1 (S) | 2 (I) | >64 (R) | 2(S) | – | – | – | KPC+ | |
| 18 | 2020/09 | SF | KPC-78 | A533C | D179A | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 0.5 (S) | 2 (I) | >64 (R) | 1(S) | – | – | KPC+ | KPC+ | |
| 19 | 2019/09 | SP | KPC-79 | TR insertion | 262V_268N dup | blaSHV-12, blaCTX-M-65, blaTEM-1, blaDHA-1, blaLAP-2 | 32 (R) | 4 (R) | 8 (R) | 64 (R) | 4(S) | Ind | – | KPC+ | KPC+ | |
a
Ind, indeterminate; TR, tandem repeat; dup, duplication; R, resistant; I, intermediary; S, sensitivity; ETP, ertapenem; IPM, imipenem; MEM, meropenem; CZA, ceftazidime-avibactam; MEV, meropenem-vaborbactam; AB, abdominal fluid; UR, urine; SP, sputum; SF, cerebrospinal fluid; MB, Mini-BAL; ND, not determined; MBL, metallo-β-lactamase.