Adaptive resistance to cefiderocol in carbapenem-resistant Acinetobacter baumannii (CRAB): microbiological and clinical issues

Desmoulin, Anissa; Sababadichetty, Loïk; Kamus, Laure; Daniel, Marion; Feletti, Lucie; Allou, Nicolas; Potron, Anaïs; Leroy, Anne-Gaëlle; Jaffar-Bandjee, Marie-Christine; Belmonte, Olivier; Garrigos, Thomas; Miltgen, Guillaume

doi:10.1016/j.heliyon.2024.e30365

Heliyon

2024

DOI: 10.1016/j.heliyon.2024.e30365

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Adaptive resistance to cefiderocol in carbapenem-resistant Acinetobacter baumannii (CRAB): microbiological and clinical issues

Anissa Desmoulin,

Loïk Sababadichetty,

Laure Kamus

et al.

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2024

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Cited by 2 publications

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New Agents Are Coming, and So Is the Resistance

Keck,

Viteri,

Schultz

et al. 2024

Antibiotics

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Antimicrobial resistance is a global threat that requires urgent attention to slow the spread of resistant pathogens. The United States Centers for Disease Control and Prevention (CDC) has emphasized clinician-driven antimicrobial stewardship approaches including the reporting and proper documentation of antimicrobial usage and resistance. Additional efforts have targeted the development of new antimicrobial agents, but narrow profit margins have hindered manufacturers from investing in novel antimicrobials for clinical use and therefore the production of new antibiotics has decreased. In order to combat this, both antimicrobial drug discovery processes and healthcare reimbursement programs must be improved. Without action, this poses a high probability to culminate in a deadly post-antibiotic era. This review will highlight some of the global health challenges faced both today and in the future. Furthermore, the new Infectious Diseases Society of America (IDSA) guidelines for resistant Gram-negative pathogens will be discussed. This includes new antimicrobial agents which have gained or are likely to gain FDA approval. Emphasis will be placed on which human pathogens each of these agents cover, as well as how these new agents could be utilized in clinical practice.

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New Agents Are Coming, and So Is the Resistance

Keck,

Viteri,

Schultz

et al. 2024

Antibiotics

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Cefiderocol-Based Regimen for Acinetobacter NDM-1 Outbreak

Travi,

Peracchi,

Merli

et al. 2024

Antibiotics

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Variable outcomes have been reported with cefiderocol in infections due to carbapenem-resistant Acinetobacter baumannii (CRAB). Nonetheless, it may be the only option for metallo-beta-lactamase-producing strains. We describe an outbreak of NDM-CRAB infections treated with cefiderocol. Thirty-eight patients were colonized and/or infected. Thirteen patients developed a systemic infection. A clinical cure was achieved in 10 (83%) patients, one VAP and 9 BSIs, at day 7. In vitro, the activity of cefiderocol does not appear to match in vivo effectiveness using currently available commercial tests. Despite high clinical cures, overall mortality remains high in severely ill patients. Cefiderocol may be considered in this specific setting, though the implementation of susceptibility tests and infection control measures is mandatory.

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Adaptive resistance to cefiderocol in carbapenem-resistant Acinetobacter baumannii (CRAB): microbiological and clinical issues

Cited by 2 publications

References 17 publications

New Agents Are Coming, and So Is the Resistance

New Agents Are Coming, and So Is the Resistance

Cefiderocol-Based Regimen for Acinetobacter NDM-1 Outbreak

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