The emergence of cefiderocol resistance in Pseudomonas aeruginosa from a heteroresistant isolate during prolonged therapy

Cefiderocol is a siderophore cephalosporin designed to target multi-drug-resistant Gram-negative bacteria. Previously, the emergence of cefiderocol non-susceptibility has been associated with mutations in the chromosomal cephalosporinase (PDC) along with mutations in the PirA and PiuA/D TonB-depende...

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Bibliographic Details
Published in:Antimicrobial agents and chemotherapy 2024-01, Vol.68 (1), p.e0100923
Main Authors: Teran, Nicholas, Egge, Stephanie L, Phe, Kady, Baptista, Rodrigo P, Tam, Vincent H, Miller, William R
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Cefiderocol - pharmacology
Cephalosporins - pharmacology
Drug Resistance, Multiple, Bacterial - genetics
Gram-Negative Bacteria
Humans
Mechanisms of Resistance
Microbial Genetics
Microbial Sensitivity Tests
Monobactams - pharmacology
Pseudomonas aeruginosa
Pseudomonas Infections - drug therapy
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Summary:Cefiderocol is a siderophore cephalosporin designed to target multi-drug-resistant Gram-negative bacteria. Previously, the emergence of cefiderocol non-susceptibility has been associated with mutations in the chromosomal cephalosporinase (PDC) along with mutations in the PirA and PiuA/D TonB-dependent receptor pathways. Here, we report a clinical case of cefiderocol-resistant that emerged in a patient during treatment. This resistance was associated with mutations not previously reported, suggesting potential novel pathways to cefiderocol resistance.
ISSN:0066-4804
1098-6596
1098-6596
DOI:10.1128/aac.01009-23