The emergence of cefiderocol resistance in <i>Pseudomonas aeruginosa</i> from a heteroresistant isolate during prolonged therapy
Nicholas S Teran, Stephanie L Egge, Kady Phe, Rodrigo P. Baptista, Vincent H. Tam, William R. Miller
Abstract
ABSTRACT 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 P. aeruginosa that emerged in a patient during treatment. This resistance was associated with mutations not previously reported, suggesting potential novel pathways to cefiderocol resistance.
Topics & Concepts
Pseudomonas aeruginosaCephalosporinSiderophoreBiologyMicrobiologyBacteriaDrug resistanceGeneticsAntibioticsAntibiotic Resistance in BacteriaBacterial biofilms and quorum sensingAntibiotics Pharmacokinetics and Efficacy