Antimicrobial Activity of Ceftolozane-Tazobactam, Ceftazidime-Avibactam, and Cefiderocol against Multidrug-Resistant Pseudomonas aeruginosa Recovered at a German University Hospital

Abstract

After testing ceftolozane-tazobactam, ceftazidime-avibactam, and cefiderocol against a collection of 233 multidrug-resistant (MDR) Pseudomonas aeruginosa , we showed that cefiderocol is the most active antipseudomonal β-lactam agent (susceptibility rates were 46.6%, 48.4%, and 97.4%, respectively). The most prevalent one was sequence type 235 (ST235) (24.7%), followed by ST244, ST175, and ST233, with all belonging to the top 10 P. aeruginosa high-risk clones with worldwide distribution.

Cefiderocol Efficacy in a Real-Life Setting: Single-Centre Retrospective Study

“…All bacterial isolates were carbapenem-resistant (MIC > 8 mg/L) [ 15 ]; they are summarized in Table 1 and shown in Figure 3 . The most isolated bacteria were CRAB (75.6%).…”

“…The main real-life studies regarding CFD are reported in Table 4 . The 30-D mortality in these studies ranged from 12.5 to 60% [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. This wide variability is probably due to the different conditions of the patients described in these studies.…”

“…Real-world data shows a large variability of CFD efficacy in different infections [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Falcone et al found that although there was a significant benefit to clinical outcomes in BSIs of CFD over colistin-containing regimens ( p = 0.007), this benefit was not found in VAPs caused by CRAB ( p = 0.918); the authors supposed that these findings could be due to baseline features of these patients, such as COVID-19 coinfection, which makes it difficult to assess the actual efficacy of antibiotic therapy [ 12 ].…”

In Vivo Development of Aztreonam Resistance in Meropenem-Resistant Pseudomonas aeruginosa Owing to Overexpression of the bla PDC-16

“…The choice of antimicrobial agents for treating infections caused by MBL-producing P. aeruginosa is limited because MBL-producing P. aeruginosa often plays resistance to a variety of antimicrobial agents (including carbapenems and ceftazidime-avibactam). It is gratifying that several current antimicrobial agents showed good in vitro activity against MBL-producing P. aeruginosa , such as cefiderocol and cefepime-zidebactam ( 23 , 24 ). In this study, the susceptibility of cefiderocol and cefepime-zidebactam were not affected by the expression of PDC-16 .…”

Alternatives Therapeutic Approaches to Conventional Antibiotics: Advantages, Limitations and Potential Application in Medicine

“…; Enterococcus spp. ; Acinetobacter spp., Clostridium difficile , and other resistant pathogens (such as carbapenemase makers) [ 64 , 65 , 66 , 67 ].…”