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Peer-reviewedCC BY 4.0International Journal of Molecular Sciences

Association of Carbapenemase Gene Profiles with Ceftazidime–avibactam Resistance in Carbapenem-Resistant Klebsiella pneumoniae

  • Elif Tuğçe Güner1
  • Ayfer Bakır1
  • Cemal Çiçek1
  • Murat Aral1
  1. 1Department of Medical Microbiology, University of Health Science Ankara Etlik City Hospital, Ankara 06170, Türkiye
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Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major healthcare threat, and carbapenemase genotype may influence ceftazidime–avibactam (CZA) susceptibility. This study evaluated the association between carbapenemase gene profiles and CZA resistance in CRKP isolates. In this retrospective laboratory-based study, 184 CRKP isolates (92 CZA-susceptible and 92 CZA-resistant) were analyzed. Carbapenemase genes were detected by multiplex real-time PCR, and gene distributions and profiles were compared according to CZA susceptibility. NDM was detected in 82.6% of CZA-resistant isolates but in none of the susceptible isolates (q < 0.001). All CZA-susceptible isolates carried a single carbapenemase gene, whereas 68.5% of resistant isolates carried two or more genes. NDM + OXA-48-like was the predominant profile among resistant isolates (63.0%), while OXA-48-like alone predominated among susceptible isolates (92.4%) (both q < 0.001). NDM showed 82.6% sensitivity and 100% specificity for discriminating CZA resistance, with an AUC of 0.913. Amikacin resistance was also higher among CZA-resistant isolates (60.9% vs. 31.5%; q < 0.001). NDM, particularly when co-occurring with OXA-48-like, was strongly associated with CZA resistance. Rapid carbapenemase genotyping may complement phenotypic susceptibility testing and support antimicrobial treatment decisions.

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Cite

BibTeXRIS
BibTeX
@article{guner2026association,
  title = {{Association of Carbapenemase Gene Profiles with Ceftazidime–avibactam Resistance in Carbapenem-Resistant Klebsiella pneumoniae}},
  author = {Elif Tuğçe Güner and Ayfer Bakır and Cemal Çiçek and Murat Aral},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = oct,
  doi = {10.3390/ijms27209386},
  url = {https://www.mdpi.com/1422-0067/27/20/9386},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association of Carbapenemase Gene Profiles with Ceftazidime–avibactam Resistance in Carbapenem-Resistant Klebsiella pneumoniae
AU  - Elif Tuğçe Güner
AU  - Ayfer Bakır
AU  - Cemal Çiçek
AU  - Murat Aral
PY  - 2026
DA  - 2026/10/21
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27209386
UR  - https://www.mdpi.com/1422-0067/27/20/9386
AB  - Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major healthcare threat, and carbapenemase genotype may influence ceftazidime–avibactam (CZA) susceptibility. This study evaluated the association between carbapenemase gene profiles and CZA resistance in CRKP isolates. In this retrospective laboratory-based study, 184 CRKP isolates (92 CZA-susceptible and 92 CZA-resistant) were analyzed. Carbapenemase genes were detected by multiplex real-time PCR, and gene distributions and profiles were compared according to CZA susceptibility. NDM was detected in 82.6% of CZA-resistant isolates but in none of the susceptible isolates (q < 0.001). All CZA-susceptible isolates carried a single carbapenemase gene, whereas 68.5% of resistant isolates carried two or more genes. NDM + OXA-48-like was the predominant profile among resistant isolates (63.0%), while OXA-48-like alone predominated among susceptible isolates (92.4%) (both q < 0.001). NDM showed 82.6% sensitivity and 100% specificity for discriminating CZA resistance, with an AUC of 0.913. Amikacin resistance was also higher among CZA-resistant isolates (60.9% vs. 31.5%; q < 0.001). NDM, particularly when co-occurring with OXA-48-like, was strongly associated with CZA resistance. Rapid carbapenemase genotyping may complement phenotypic susceptibility testing and support antimicrobial treatment decisions.
SN  - 1422-0067
ER  -