Structural Basis of Reduced Susceptibility to Ceftazidime-Avibactam and Cefiderocol in <i>Enterobacter cloacae</i> Due to AmpC R2 Loop Deletion
Akito Kawai, Christi L. McElheny, Alina Iovleva, Ellen G Kline, Nicolas Sluis‐Cremer, Ryan K. Shields, Yohei Doi
Abstract
Ceftazidime-avibactam and cefiderocol are two of the latest generation β-lactam agents that possess expanded activity against highly drug-resistant bacteria, including carbapenem-resistant Enterobacterales . Here, we show that structural changes in AmpC β-lactamases can confer reduced susceptibility to both agents. A multidrug-resistant Enterobacter cloacae clinical strain (Ent385) was found to be resistant to ceftazidime-avibactam and cefiderocol without prior exposure to either agent.
Topics & Concepts
Enterobacter cloacaeCeftazidime/avibactamCeftazidimeAvibactamMicrobiologyEnterobacterCephalosporinEnterobacteriaceaeBiologyPseudomonas aeruginosaBacteriaAntibioticsEscherichia coliBiochemistryGeneticsGeneAntibiotic Resistance in BacteriaAntibiotics Pharmacokinetics and EfficacyDrug Transport and Resistance Mechanisms