Stepwise within-host evolution of a blaCTX-M-27-positive Klebsiella pneumoniae clone under changing antimicrobial pressures leading to enhancement of β-lactam resistance.

Abstract excerpt

OBJECTIVE: We consecutively obtained four blaCTX-M-27-positive Klebsiella pneumoniae isolates (named KE411, KE412, KE413, and KE414) from a patient with acute leukemia who underwent sequential antimicrobial therapy. These isolates exhibited a stepwise increase in β-lactam resistance alongside changes in the antibiotic treatment and ultimately acquired resistance to all β-lactams examined, including carbapenems....

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