ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Antibiotic Resistance and New Antimicrobial drugs
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1616353
This article is part of the Research TopicESKAPEing host endogenous and exogenous defenses: new insights into the ability of multidrug- resistant bacteria to overcome host defenses and antimicrobial compounds activityView all 4 articles
Meropenem/Vaborbactam Activity Against Carbapenem-resistant Klebsiella pneumoniae from Catheter-Related Bloodstream Infections
Provisionally accepted
Francesca Sivori1
Massimo Francalancia1
Mauro Truglio1*
ILARIA CAVALLO1
Carmelina Pronesti2
Giorgia Fabrizio3Ilaria Celesti1Andrea Cazzani1Lorenzo Furzi1
FULVIA PIMPINELLI1
Enea Gino Di Domenico1- 1Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Lazio, Italy
- 2Hospital Physiotherapy Institutes (IRCCS), Rome, Lazio, Italy
- 3Department of Biology and Biotechnology Charles Darwin, Faculty of Mathematics, Physics, and Natural Sciences, Sapienza University of Rome, Rome, Lazio, Italy
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Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat in oncology settings due to its multidrug resistance and ability to form biofilms on indwelling medical devices. This study investigated the in vitro and in vivo activity of meropenem/vaborbactam (MEV) against two CRKP isolates recovered from catheter-related bloodstream infections in patients undergoing orthopedic oncologic surgery. Whole-genome sequencing identified the isolates as ST101 and ST307, harboring resistance determinants including blaKPC-3 and blaOXA-1, distributed across IncFII and IncFIB plasmid replicons. Both isolates exhibited extensive resistance to β-lactams, aminoglycosides, and fluoroquinolones but remained susceptible to MEV. Phenotypic assays revealed enhanced biofilm formation and metabolic activity compared to the reference strain Kp ATCC 13883 in the absence of hypervirulence-associated genes. MEV demonstrated bactericidal activity against both planktonic and biofilm-associated cells, with minimum bactericidal concentration (MBC₉₀) and minimum biofilm eradication concentration (MBEC₉₀) values of 0.5/8 μg/ml for CRKP ST101, 0.12/8 μg/ml for CRKP ST307, and 0.25/8 μg/ml for the Kp ATCC 13883 strain. In the Galleria mellonella infection model, MEV significantly improved larval survival following the CRKP challenge. These findings demonstrate that MEV exhibits activity against planktonic and biofilm-associated CRKP cells and highlight the need for further investigation in managing catheterrelated bloodstream infections caused by multidrug-resistant K. pneumoniae.
Keywords: carbapenem-resistant Klebsiella pneumoniae, multidrug-resistant plasmid, Meropenem/Vaborbactam, Catheter-related bloodstream infections, biofilm-associated infections, Surgical site infection
Received: 22 Apr 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Sivori, Francalancia, Truglio, CAVALLO, Pronesti, Fabrizio, Celesti, Cazzani, Furzi, PIMPINELLI and Di Domenico. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mauro Truglio, Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Lazio, Italy
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