Cefiderocol susceptibility of Achromobacter spp.: study of an accurately identified collection of 230 strains
Vincent Jean-Pierre, Pauline Sorlin, Alix Pantel, R. Chiron, Jean‐Philippe Lavigne, Katy Jeannot, Hélène Marchandin, Collaborative study group on antimicrobial resistance of Achromobacter spp., Marlène Amara, Lucile Cadot, Olivier Dauwalder, Nicolas Degand, Magalie Demar, Clarisse Dupin, Marie-Sarah Fangous, Claire Franczak, Fabien Garnier, Pascal Guiet, Jérôme Guinard, Cécile Hombrouck-Alet, Atika Kaoula, Patricia Mariani‐Kurkdjian, Niels Nørskov‐Lauritsen, Frédéric Schramm, Charlotte Tellini, Anthony Texier, Jérémie Violette, Nathalie Wilhelm
Abstract
BACKGROUND: Achromobacter spp. are opportunistic pathogens, mostly infecting immunocompromised patients and patients with cystic fibrosis (CF) and considered as difficult-to-treat pathogens due to both intrinsic resistance and the possibility of acquired antimicrobial resistance. Species identification remains challenging leading to imprecise descriptions of resistance in each taxon. Cefiderocol is a broad-spectrum siderophore cephalosporin increasingly used in the management of Achromobacter infections for which susceptibility data remain scarce. We aimed to describe the susceptibility to cefiderocol of a collection of Achromobacter strains encompassing different species and isolation sources from CF or non-CF (NCF) patients. METHODS: We studied 230 Achromobacter strains (67 from CF, 163 from NCF patients) identified by nrdA gene-based analysis, with available susceptibility data for piperacillin-tazobactam, meropenem and trimethoprim-sulfamethoxazole. Minimal inhibitory concentrations (MICs) of cefiderocol were determined using the broth microdilution reference method according to EUCAST guidelines. RESULTS: of ≤ 0.015/0.5 mg/L overall and 0.125/2 mg/L against 27 (11.7%) meropenem-non-susceptible strains. Cefiderocol MICs were not related to CF/NCF origin or species although A. xylosoxidans MICs were statistically lower than those of other species considered as a whole. Considering the EUCAST non-species related breakpoint (2 mg/L), 228 strains (99.1%) were susceptible to cefiderocol. The two cefiderocol-resistant strains (A. xylosoxidans from CF patients) represented 3.7% of meropenem-non-susceptible strains and 12.5% of MDR strains. CONCLUSIONS: Cefiderocol exhibited excellent in vitro activity against a large collection of accurately identified Achromobacter strains, irrespective of species and origin.