Emergence of Ceftazidime-avibactam Resistance and Molecular Characteristics among carbapenem-resistant Pseudomonas aeruginosa Clinical Isolates

The aim of our study is to evaluate the current resistant situation of CZA among CRPA strains in vitro and further investigate the resistant mechanisms, using isolates collected from nine hospitals in Guangdong Province from 2018 to 2020. A total of 250 CRPA clinical isolates were collected. The antimicrobial susceptibility profile of these strains was determined. A subset of sixteen CZA-resistant CRPA isolates was analyzed by whole genome sequencing (WGS). Phylogenomic analysis and carbapenem resistant plasmid comparison were performed. To screen possible genetic causes of resistance towards CZA in CRPA isolates, the associations between accessory genes or single-nucleotide polymorphisms (cgSNPs) was identified and the resistance trait were calculated.