Evidence map›Paper›PMID 40866524›Full record

ArticleScientific reports2025

Cefiderocol-resistant pathogens in German hospital wastewater: a reservoir for multidrug resistance.

Tim Erler, Laura Carlsen, Jennifer Dengler, Jens Andre Hammerl, Andreas J Stroehlein, Marc Hoffmann, Johannes K Knobloch, Christoph Lübbert, Cihan Papan, Thomas Schwanz and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. From Environmental Organism to Nosocomial Threat:Antibiotics (Basel, Switzerland) · 2026
    Review
  2. Article
  3. Review
  4. Article
  5. Review
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

16 authors.

Tim ErlerInstitute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Laura CarlsenInstitute of Medical Microbiology, Virology, and Hygiene, Department for Infection Prevention and Control, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jennifer DenglerIntegrative Health and Security Management Center, Staff Section Environmental Protection and Sustainability, Jena University Hospital, Jena, Germany.
Jens Andre HammerlDepartment for Biological Safety, German Federal Institute for Risk Assessment, Berlin, Germany.
Andreas J StroehleinDepartment for Biological Safety, German Federal Institute for Risk Assessment, Berlin, Germany.
Marc HoffmannIntegrative Health and Security Management Center, Staff Section Environmental Protection and Sustainability, Jena University Hospital, Jena, Germany.
Johannes K KnoblochInstitute of Medical Microbiology, Virology, and Hygiene, Department for Infection Prevention and Control, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christoph LübbertDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, Leipzig University Hospital, Leipzig, Germany.
Cihan PapanInstitute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Thomas SchwanzDivision of Infection Control and Infectious Diseases, University Hospital RWTH Aachen, Aachen, Germany.
Janine ZweignerDepartment of Hospital Hygiene and Infection Control, University Hospital of Cologne, Cologne, Germany.
Anurag Kumar BariDepartment of Medical Microbiology and Infection Control, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Basil Britto XavierDepartment of Medical Microbiology and Infection Control, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
John W A RossenDepartment of Medical Microbiology and Infection Control, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Nico T Mutters *Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Mykhailo Savin *Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. michael.savin-hoffmeyer@ukbonn.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cefiderocol-resistant bacteria pose a growing concern in both clinical and environmental settings. This study investigates cefiderocol-resistant bacteria in wastewater from six German tertiary care hospitals. A total of 36 samples were analysed using a culture-dependent approach involving cefiderocol pre-enrichment, yielding 97 cefiderocol-resistant isolates-primarily Enterobacter roggenkampii, Klebsiella oxytoca, Serratia marcescens, and Citrobacter farmeri. Most isolates exhibited high minimum inhibitory concentrations against cefiderocol and resistance to multiple antibiotics. Resistance rates were lower for meropenem-vaborbactam (10.3%) and imipenem-relebactam (33.0%), while all isolates remained susceptible to aztreonam-avibactam. Whole-genome sequencing of 79 isolates revealed a diverse resistome, with 78.5% (62/79) carrying carbapenemase genes. Some isolates harbored up to six distinct β-lactamase genes, including combinations of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and one or multiple carbapenemases-such as as bla

Indexed as

Anti-Bacterial AgentsCephalosporinsDrug Resistance, Multiple, BacterialWastewaterBacterial Proteinsbeta-LactamasesGermanyHospitalsHumansMicrobial Sensitivity TestsWhole Genome SequencingAnti-Bacterial AgentsBacterial Proteinsbeta-LactamasescarbapenemaseCephalosporinsWastewaterCarbapenemasesCefiderocol resistanceMultidrug-resistant pathogensPandrug-resistant bacteriaPlasmid incompatibility typesWastewater surveillance

Identifiers

PMID40866524
PMCPMC12391349

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Registered trials

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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.