ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025
Combined resistance mechanisms leading to high-level of cefiderocol resistance among NDM-like producing E. coli ST167 clinical isolates.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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.
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.
Who cites it
5 citing papers in PubMed.
- Rising Incidence of New Delhi Metallo-β-Lactamase-Producing Carbapenem-Resistant Enterobacterales, 10 US Sites, 2018-2023.Open forum infectious diseases · 2026Article
- In vitro activity of aztreonam/avibactam and comparators against Enterobacterales isolates from patients with hospital-acquired pneumonia, ventilator-associated pneumonia, and complicated intra-abdominal infections (ATLAS, 2021-2022).The Journal of antimicrobial chemotherapy · 2026Article
- In vitro selection of cefiderocol-resistant mutants in Acinetobacter baumannii harbouring the most common carbapenemase genes.The Journal of antimicrobial chemotherapy · 2026Article
- Small colony variants and cefiderocol resistance in clinicalFrontiers in microbiology · 2026Article
- Molecular Epidemiology and Multilevel Drug Resistance Mechanisms ofInfection and drug resistance · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA series of NDM-producing Escherichia coli ST167 clinical isolates exhibiting resistance to cefiderocol (FDC), with no previous exposure to this antibiotic, were analyzed in this study.
methodsThe antimicrobial susceptibility testing and phenotypic detection of resistance patterns (Rapid Cefiderocol NP test and MIC determination) were performed for all tested isolates. Their entire genomes were sequenced by using the Illumina MiSeq platform and high-quality reads were de-novo assembled using the CLC Genomic Workbench. Genome-sequence based characteristics were analyzed using bioinformatics tools.
resultsAll NDM-producing E. coli ST167 isolates showed a high level of resistance to FDC (MICs being 64 or > 64 mg/L). The chromosomally located cirA gene, encoding a catecholate siderophore receptor in E. coli, was truncated in all FDC-resistant isolates due to a frameshift mutation (S90Y), leading to CirA-deficient isolates. A four amino acid insertion (YRIN) was also identified after residue 333 in the PBP3 protein sequence of all E. coli isolates. Among them, a single FDC-resistant NDM-5-producing E. coli isolate (1006) was additionally resistant to aztreonam/avibactam (AZA MIC of 8 mg/L). When analyzed against the genome of another FDC resistant NDM-5 producing E. coli ST167 containing a YRIN insertion in the PBP3, and exhibiting decreased susceptibility to AZA, the broad-spectrum ß-lactamase CMY-42 was identified.
conclusionWe identified a variety of NDM-producing E. coli isolates exhibiting high level of resistance to FDC as a result of the combined effect of CirA deficiency, along with production of NDM-type enzymes. The spread of such resistance phenotype across Europe poses great concern on the clinical efficacy of this novel drug. Additionally, the identification of an FDC- and AZA-resistant NDM-5 producing E. coli isolate represents one of the ultimate evolutions with a possible step towards pan-resistance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.