ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2022
In vitro activity of cefiderocol against ceftazidime-avibactam susceptible and resistant KPC-producing Enterobacterales: cross-resistance and synergistic effects.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Effect of antibiotic regimens for bloodstream infections caused by KPC-producing enterobacter: a network meta-analysis.Frontiers in medicine · 2026Pooled it
- A systematic review and individual bacterial species level meta-analysis of in vitro studies on the efficacy of ceftazidime/avibactam combined with other antimicrobials against carbapenem-resistant Gram-negative bacteria.The Journal of antimicrobial chemotherapy · 2025Pooled it
- Addressing therapeutic options for KPC-3-producing ST307-Antimicrobial agents and chemotherapy · 2026Article
- Cefiderocol in Children with Hematologic Malignancies-The Multicenter Retrospective Experience of the Infection Working Group of the Italian Pediatric Hematology and Oncology Association (AIEOP).Journal of clinical medicine · 2026Article
- Reduced catalytic activity of KPC β-lactamase can increase ceftazidime resistance.Communications biology · 2026Article
- Beyond new pills: integrative strategies to overcome multidrug-resistant bacteria.Archives of microbiology · 2026Review
- Interpretive agreement of susceptibility between broth microdilution and disk diffusion methods for cefiderocol, using criteria from the Clinical and Laboratory Standards Institute, European Committee on Antimicrobial Susceptibility Testing, and the Food and Drug Administration.Journal of clinical microbiology · 2026Article
- Innovative Antibiotics: The Experience of Cefiderocol in Carbapenem-Resistant Gram-Negative Infections.Infection and drug resistance · 2026Review
- Genomic characterization of ceftazidime/avibactam-resistant KPC-producingFrontiers in microbiology · 2026Article
- Cefiderocol: A Comprehensive Review of Chemistry, Mechanisms of Resistance, and Clinical Applications in the Era of Multidrug Resistance.Current microbiology · 2025Review
- Occurrence of KPC-71 or the presence of NDM combined with a high expression ofMicrobiology spectrum · 2025Article
- Epidemiology of Carbapenem-Resistant Klebsiella Pneumoniae Co-Producing MBL and OXA-48-Like in a Romanian Tertiary Hospital: A Call to Action.Antibiotics (Basel, Switzerland) · 2025Article
- Newly developed antibiotics against multidrug-resistant and carbapenem-resistant Gram-negative bacteria: action and resistance mechanisms.Archives of microbiology · 2025Review
- Carbapenem-resistant Gram-negative bacteria exhibiting clinically undetected cefiderocol heteroresistance leads to treatment failure in a murine model of infection.Frontiers in microbiology · 2025Article
- Updates on the Activity, Efficacy and Emerging Mechanisms of Resistance to Cefiderocol.Current issues in molecular biology · 2024Review
- In vivo development of resistance to novel β-lactam/β-lactamase inhibitor combinations in KPC-producing Klebsiella pneumoniae infections: a case series.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Article
- Complete Genome Sequence of aPathogens (Basel, Switzerland) · 2024Article
- Effect of ceftazidime-avibactam combined with different antimicrobials against carbapenem-resistantMicrobiology spectrum · 2024Article
- Evolution of ceftazidime-avibactam and cefiderocol resistance in ST131-H30R1-Microbiology spectrum · 2024Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the in vitro activity of cefiderocol (CFDC) against a collection of both ceftazidime-avibactam (CZA) susceptible and resistant KPC-producing Enterobacterales (KPC-EB) isolates. Secondly, to assess its synergistic activity in combination with different antibiotics.
methodsOne hundred KPC-EB isolates were tested: 60 CZA susceptible and 40 CZA resistant. Among them, 17 pairs of CZA susceptible and resistant KPC-producing Klebsiella pneumoniae (KPC-Kp) isolates were collected from 17 distinct patients before and after CZA treatment, respectively. CFDC susceptibility was evaluated by both broth microdilution (lyophilized panels; Sensititre; Thermo Fisher) and disk diffusion testing. Results were interpreted using EUCAST breakpoints. Synergistic activity of CFDC in combination with CZA, meropenem-vaborbactam, imipenem, and amikacin against six characterized KPC-Kp strains, before and after acquisition of CZA resistance, was evaluated using gradient diffusion strip crossing method.
resultsCFDC resistance rate was significantly higher in CZA resistant EB subset than in the susceptible one (p < 0.001): 82.5% vs 6.7%. MIC50 and MIC90 values were 0.25 and 2 mg/L, 8 and 64 mg/L in CZA-susceptible and CZA-resistant subset, respectively. KPC-Kp isolates harboring KPC-D179Y or KPC-Δ242-GT-243 variants showed CFDC MICs ranging from 4 to 64 mg/L. CFDC showed in vitro synergistic effect mostly with CZA, against both CZA susceptible and resistant isolates, resulting in a synergy rate of 66.7%.
conclusionsCZA resistance mechanisms in KPC-EB impair the in vitro activity of CFDC, often leading to co-resistance. CFDC in combination with the new β-lactamases inhibitors might represent a strategy to enhance its activity.
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