Work

Failure of durlobactam to restore the susceptibility to meropenem in carbapenem-resistant Klebsiella pneumoniae

Year: 2026

Type: article

Abstract: OBJECTIVE: Durlobactam, a diazabicyclooctane β-lactamase inhibitor, can protect meropenem from hydrolysis of KPC and OXA-48 carbapenemases. This study aims to characterise the genome of a carbapenem-resistant Klebsiella pneumoniae clinical strain with a high MIC (256 mg/L) of meropenem in the presence of durlobactam. METHODS: The strain was recovered from bile and MICs of meropenem-durlobactam and sulbactam-durlobactam were determined using broth microdilution. Its genome was sequenced using the Illumina platform and was analysed for antimicrobial-resistance genes and virulence factors using a set of bioinformatic tools. RESULTS: and carried virulence factors encoding aerobactin, (iutA-iuc), yersiniabactin (irp-ybt), and mucoid regulators (rmpADC and rmpA2), suggesting enhanced virulence. MICs of meropenem-durlobactam and sulbactam-durlobactam against this strain were both 256/4 mg/L. CONCLUSIONS: A KPC-2-producing carbapenem-resistant K. pneumoniae with non-susceptibility to meropenem-durlobactam, possibly linked to porin LamB deficiency and the absence of outer membrane assembly protein AsmA, was identified. This uncovers a new challenge caused by antimicrobial resistance and calls for more surveillance.

Source: Journal of Global Antimicrobial Resistance

DOI: 10.1016/j.jgar.2026.03.002

Authors: Hongxia Wen, Yu Feng, Zhiyong Zong

Institutions: Sichuan University, West China Hospital of Sichuan University, West China Medical Center of Sichuan University, State Key Laboratory of Biotherapy

Language: English

Topic: Antibiotic Resistance in Bacteria

Subfield: Molecular Medicine

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,890