Evidence map›Paper›PMID 34079986›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Rapid Development of Cefiderocol Resistance in Carbapenem-resistant Enterobacter cloacae During Therapy Is Associated With Heterogeneous Mutations in the Catecholate Siderophore Receptor cirA.

Sabrina Klein, Sébastien Boutin, Kaan Kocer, Mascha O Fiedler, Dominic Störzinger, Markus A Weigand, Benjamin Tan, Daniel Richter, Christian Rupp, Markus Mieth and 5 more

Open access · hybridAbstract readCase Reports
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed
5.9field-weighted citation impact, top 2% 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

74 citing papers in PubMed, 106 citations in OpenAlex.

  1. ISEmerging microbes & infections · 2026
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  3. Influence of iron uptake systems on cefiderocol activity inAntimicrobial agents and chemotherapy · 2026
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  13. Review
  14. Siderophore cephalosporins.EcoSal Plus · 2025
    Review
  15. Review
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article

14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Sabrina KleinDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg,Germany.
Sébastien BoutinDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg,Germany.
Kaan KocerDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg,Germany.
Mascha O FiedlerDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg,Germany.
Dominic StörzingerPharmacy Department, Heidelberg University Hospital, Heidelberg, Germany.
Markus A WeigandDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg,Germany.
Benjamin TanDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg,Germany.
Daniel RichterDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg,Germany.
Christian RuppDepartment of Internal Medicine IV, Heidelberg University Hospital, Heidelberg, Germany.
Markus MiethDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Arianeb MehrabiDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Thilo HackertDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Stefan ZimmermannDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg,Germany.
Klaus HeegDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg,Germany.
Dennis NurjadiDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg,Germany.ORCID 0000-0002-1278-5939
Heidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report a case of resistance development toward cefiderocol in a patient with intra-abdominal and bloodstream infections caused by carbapenemase-producing Enterobacter cloacae within 21 days of cefiderocol therapy. Whole genome sequencing revealed heterogeneous mutations in the cirA gene, encoding a catecholate siderophore receptor, conferring phenotypic resistance to cefiderocol.

Indexed as

Enterobacter cloacaeSiderophoresAnti-Bacterial AgentsBacterial Proteinsbeta-LactamasesCarbapenemsCefiderocolCephalosporinsHumansMicrobial Sensitivity TestsMutationAnti-Bacterial AgentsBacterial Proteinsbeta-LactamasesCarbapenemsCefiderocolCephalosporinsSiderophoresantibiotic resistancecarbapenemaseCefiderocolcirA siderophore receptorEnterobacter cloacae

Identifiers

PMID34079986
PMCPMC8906715
OpenAlexW3165323590

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.