Rapid Development of Cefiderocol Resistance in Carbapenem-resistant Enterobacter cloacae During Therapy Is Associated With Heterogeneous Mutations in the Catecholate Siderophore Receptor cirA

Abstract We report a case of resistance development toward cefiderocol in a patient with intra-abdominal and bloodstream infections caused by carbapenemase-producing Enterobacter cloacae within 21 days of cefiderocol therapy. Whole genome sequencing revealed heterogeneous mutations in the cirA gene,...

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Bibliographic Details
Published in:Clinical infectious diseases 2022-03, Vol.74 (5), p.905-908
Main Authors: Klein, Sabrina, Boutin, Sébastien, Kocer, Kaan, Fiedler, Mascha O, Störzinger, Dominic, Weigand, Markus A, Tan, Benjamin, Richter, Daniel, Rupp, Christian, Mieth, Markus, Mehrabi, Arianeb, Hackert, Thilo, Zimmermann, Stefan, Heeg, Klaus, Nurjadi, Dennis
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Bacterial Proteins - genetics
beta-Lactamases - genetics
Brief Reports
Carbapenems - pharmacology
Carbapenems - therapeutic use
Cefiderocol
Cephalosporins
Enterobacter cloacae - genetics
Humans
Microbial Sensitivity Tests
Mutation
Siderophores - therapeutic use
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Summary:Abstract We report a case of resistance development toward cefiderocol in a patient with intra-abdominal and bloodstream infections caused by carbapenemase-producing Enterobacter cloacae within 21 days of cefiderocol therapy. Whole genome sequencing revealed heterogeneous mutations in the cirA gene, encoding a catecholate siderophore receptor, conferring phenotypic resistance to cefiderocol.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciab511