Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections

Nathaniel C Warner¹, Luther A Bartelt¹, Anne M Lachiewicz¹, Kathleen M Tompkins¹, Melissa B Miller^{2

3}, Kevin Alby^{2

3}, Melissa B Jones², Amy L Carr⁴, Jose Alexander⁵, Andrew B Gainey⁶, Robert Daniels⁶, Anna-Kathryn Burch^{6

7}, David E Brown^{6

7}, Michael J Brownstein⁸, Faiqa Cheema⁹, Kristin E Linder¹⁰, Ryan K Shields^{11

12}, Sarah Longworth¹³, David van Duin¹

Affiliations

¹ Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
² Clinical Microbiology Laboratory, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
³ Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
⁴ Department of Pharmacy, Advent Health Orlando, Orlando, Florida, USA.
⁵ Department of Microbiology/Virology/Immunology, Advent Health, Orlando, Florida, USA.
⁶ Prisma Health Children's Hospital-Midlands, Columbia, South Carolina, USA.
⁷ Department of Pediatrics, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
⁸ Adaptive Phage Therapeutics, Gaithersburg, Maryland, USA.
⁹ Division of Infectious Diseases, University of Connecticut, Farmington, Connecticut, USA.
¹⁰ Department of Pharmacy, Hartford Hospital, Hartford, Connecticut, USA.
¹¹ Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹² Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹³ Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

PMID: 33313656
PMCID: PMC8678443
DOI: 10.1093/cid/ciaa1847

Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections

Nathaniel C Warner et al. Clin Infect Dis. 2021.

. 2021 Oct 5;73(7):e1754-e1757.

doi: 10.1093/cid/ciaa1847.

Authors

Affiliations

¹ Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
² Clinical Microbiology Laboratory, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
³ Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
⁴ Department of Pharmacy, Advent Health Orlando, Orlando, Florida, USA.
⁵ Department of Microbiology/Virology/Immunology, Advent Health, Orlando, Florida, USA.
⁶ Prisma Health Children's Hospital-Midlands, Columbia, South Carolina, USA.
⁷ Department of Pediatrics, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
⁸ Adaptive Phage Therapeutics, Gaithersburg, Maryland, USA.
⁹ Division of Infectious Diseases, University of Connecticut, Farmington, Connecticut, USA.
¹⁰ Department of Pharmacy, Hartford Hospital, Hartford, Connecticut, USA.
¹¹ Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹² Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹³ Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

PMID: 33313656
PMCID: PMC8678443
DOI: 10.1093/cid/ciaa1847

Abstract

Treatment options for Achromobacter xylosoxidans are limited. Eight cystic fibrosis patients with A. xylosoxidans were treated with 12 cefiderocol courses. Pretreatment in vitro resistance was seen in 3 of 8 cases. Clinical response occurred after 11 of 12 treatment courses. However, microbiologic relapse was observed after 11 of 12 treatment courses, notably without emergence of resistance.

Keywords: Achromobacter xylosoxidans; cefiderocol; cystic fibrosis; lung transplantation; pneumonia.

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References

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1. Gainey AB, Burch AK, Brownstein MJ, et al. Combining bacteriophages with cefiderocol and meropenem/vaborbactam to treat a pan-drug resistant Achromobacter species infection in a pediatric cystic fibrosis patient. Pediatr Pulmonol 2020; 55:2990–4. - PubMed
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Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections

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Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections

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