Evidence map›Paper›PMID 41400823›Full record

ArticleThe Journal of antimicrobial chemotherapy2026

Preventing resistance development in infections by OXA β-lactamase-producing Pseudomonas aeruginosa: correlating clinical outcomes with hollow-fibre model input.

María M Montero, Almudena Fernández-Muñoz, Sandra Domene-Ochoa, Silvia Castañeda, Inmaculada López-Montesinos, Sara Cortes-Lara, Sonia Luque, Maria Asunción Colomar, Xavier Mulet, Carla López-Causapé and 4 more

Abstract readCase Reports
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Ceftazidime-avibactam resistance evolution inAntimicrobial agents and chemotherapy · 2026
    Article
  2. Article
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

14 authors.

María M MonteroInfectious Diseases Service, Hospital del Mar. Infectious Pathology and Antimicrobials Research Group (IPAR), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.ORCID 0000-0001-5991-6804
Almudena Fernández-MuñozServicio de Microbiología y Unidad de Investigación, Hospital Son Espases, IdISBa, Palma de Mallorca, Spain.
Sandra Domene-OchoaInfectious Diseases Service, Hospital del Mar. Infectious Pathology and Antimicrobials Research Group (IPAR), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.
Silvia CastañedaInfectious Diseases Service, Hospital del Mar. Infectious Pathology and Antimicrobials Research Group (IPAR), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.
Inmaculada López-MontesinosInfectious Diseases Service, Hospital del Mar. Infectious Pathology and Antimicrobials Research Group (IPAR), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.
Sara Cortes-LaraServicio de Microbiología y Unidad de Investigación, Hospital Son Espases, IdISBa, Palma de Mallorca, Spain.
Sonia LuqueCIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Madrid, Spain.ORCID 0000-0002-3215-320X
Maria Asunción ColomarCIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Madrid, Spain.
Xavier MuletCIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Madrid, Spain.
Carla López-CausapéCIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Madrid, Spain.ORCID 0000-0003-2228-2005
Luisa SorlíInfectious Diseases Service, Hospital del Mar. Infectious Pathology and Antimicrobials Research Group (IPAR), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.ORCID 0000-0001-9562-514X
Eduardo PadillaDepartment of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain.
Juan P HorcajadaInfectious Diseases Service, Hospital del Mar. Infectious Pathology and Antimicrobials Research Group (IPAR), Hospital del Mar Research Institute (IMIM), Barcelona, Spain.
Antonio OliverCIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Madrid, Spain.

Funding

CIBER of Infectious Diseases CB21/13/00099CIBER of Infectious Diseases CIBERINFEC CB21/13/00002European UnionInstitute of Health Carlos III PI21/00043Institute of Health Carlos III PI22/00011Institute of Health Carlos III PI24/0010Ministerio de Economía y Competitividad of Spain
6 · The paper itself

Abstract

backgroundInfections caused by XDR Pseudomonas aeruginosa significantly limit treatment options. Although ceftolozane/tazobactam and ceftazidime/avibactam have emerged as promising alternatives, increasing resistance has been reported. This study describes three critically ill patients with ventilator-associated pneumonia caused by OXA-producing XDR P. aeruginosa that developed resistance to both agents during therapy.

methodsAntibiotic exposure and resistance were monitored clinically and in a hollow-fibre infection model (HFIM) to evaluate different ceftazidime/avibactam and ceftolozane/tazobactam regimens. Drug concentrations, bacterial burden and resistant mutants were assessed. Whole-genome sequencing and resistance profiling were performed on both clinical and HFIM-derived isolates.

resultsInitial patient isolates were susceptible to both antibiotics. One belonged to ST179 (OXA-10 producer), while two were ST235 (OXA-2 or OXA-2 + OXA-10 producers). Resistance emerged during therapy in all cases. In the HFIM, continuous infusion of ceftolozane/tazobactam plus meropenem achieved bacterial eradication for ST179 within 8 h. For ST235 isolates, high-exposure ceftazidime/avibactam regimens (4-h or continuous infusion) achieved bacterial eradication and prevented regrowth. In contrast, low-exposure 2-h infusions allowed bacterial rebound and resistance selection. Mechanisms of resistance were similar across clinical and HFIM isolates, involving overexpression or structural modification of OXA enzymes, except in one ST235 HFIM derived-isolate, in which resistance development was caused by an AmpC Ω-loop mutation. Pharmacokinetic validation confirmed accurate drug exposure in the model.

conclusionsThese findings underscore the importance of optimized dosing strategies, particularly high-concentration and prolonged infusions, in eradicating and preventing resistance development in OXA-producing P. aeruginosa infections.

Indexed as

Anti-Bacterial Agentsbeta-LactamasesDrug Resistance, Multiple, BacterialPneumonia, Ventilator-AssociatedPseudomonas aeruginosaPseudomonas InfectionsAgedAzabicyclo Compoundsbeta-Lactamase InhibitorsCeftazidimeCephalosporinsDrug CombinationsFemaleHumansMaleMicrobial Sensitivity TestsAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo Compoundsbeta-Lactamase Inhibitorsbeta-LactamasesCeftazidimeceftolozane, tazobactam drug combinationCephalosporinsDrug CombinationsTazobactam

Identifiers

PMID41400823
PMCPMC12802920

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.