Evidence map›Paper›PMID 32236408›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020

Clinical Evolution of AmpC-Mediated Ceftazidime-Avibactam and Cefiderocol Resistance in Enterobacter cloacae Complex Following Exposure to Cefepime.

Ryan K Shields, Alina Iovleva, Ellen G Kline, Akito Kawai, Christi L McElheny, Yohei Doi

Open access · greenAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 2 pooled it
4.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 93 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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  6. Article
  7. Article
  8. Genetic basis of cefiderocol resistance inMicrobiology spectrum · 2026
    Article
  9. Review
  10. Article
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  14. Article
  15. Article
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  17. Article
  18. Frontiers in microbiology · 2025
    Article
  19. Review
  20. Antimicrobial agents and chemotherapy · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Ryan K ShieldsDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Alina IovlevaDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Ellen G KlineDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Akito KawaiDepartment of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Christi L McElhenyDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Yohei DoiDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
University of Pittsburgh · USFujita Health University · JP

Funding

Colistin-resistant Acinetobacter baumanniiR01AI104895 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI DOI, YOHEI, ERNST, ROBERT K · 2014 to 2024
$4.2M
Caspofungin pharmacokinetics-pharmacodynamics during intra-adbominal candidiasisK08AI114883 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SHIELDS, RYAN K · 2015 to 2019
$858k
Study Network of Acinetobacter as a Carbapenem-Resistant Pathogen (SNAP)R21AI135522 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI DOI, YOHEI · 2018 to 2019
$460k
Use of site-specific pharmacokinetics to optimize antibiotic combinations and prevent the emergence of resistance against CRER21AI151363 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SHIELDS, RYAN K · 2021 to 2022
$431k
Mechanisms of cefiderocol resistanceR21AI151362 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI DOI, YOHEI · 2020 to 2021
$420k
Characterization and suppression of resistance to new CRE agentsR03AI144636 · NIAID · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SHIELDS, RYAN K · 2019 to 2020
$157k
NIAID NIH HHS K08 AI114883NIAID NIH HHS R01 AI104895NIAID NIH HHS R03 AI144636NIAID NIH HHS R21 AI135522NIAID NIH HHS R21 AI151362NIAID NIH HHS R21 AI151363
6 · The paper itself

Abstract

We report 2 independent patients from whom carbapenem and ceftazidime-avibactam-resistant Enterobacter cloacae complex strains were identified. The ceftazidime-avibactam resistance was attributed to a 2-amino acid deletion in the R2 loop of AmpC β-lactamase, which concurrently caused resistance to cefepime and reduced susceptibility to cefiderocol, a novel siderophore cephalosporin.

Indexed as

CephalosporinsEnterobacter cloacaeAnti-Bacterial AgentsAzabicyclo CompoundsBacterial Proteinsbeta-LactamasesCefepimeCefiderocolCeftazidimeDrug CombinationsHumansMicrobial Sensitivity TestsAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsBacterial Proteinsbeta-LactamasesCefepimeCefiderocolCeftazidimeCephalosporinsDrug CombinationscefepimedeletionR2 loopβ-lactamase

Identifiers

PMID32236408
PMCPMC7744991
OpenAlexW3015086962

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.