Mike the Mad Biologist:

The KPC gene confers resistance to all cephalosporins and ß-lactam antibiotics: basically, anything named “-cillin”, “-penem”, or “cef-” won’t kill it. Aztreonam doesn’t kill it either. And, of course, it happens to have evolved resistance to most of the other classes of antibiotics, so, like some Acinetobacter, it is only treatable with colistin and tigecycline, which works…except when resistance evolves in the patient, which has been observed multiple times (this is alarming given the relatively few times this therapy has been used). The KPC gene is found on a highly transmissible plasmid, which means it can be transferred within Klebsiella and can also spread to other Gram-negative bacteria (E. coli, Enterobacter, and others). The good news is that the plasmid is unstable: it doesn’t always manage to wind up in both daughter** cells after cell division.


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