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Case Reports
. 2024 Jun 14;78(6):1425-1428.
doi: 10.1093/cid/ciad759.

Sequential Treatment Failure With Aztreonam-Ceftazidime-Avibactam Followed by Cefiderocol Due to Preexisting and Acquired Mechanisms in a New Delhi Metallo-β-lactamase-Producing Escherichia coli Causing Fatal Bloodstream Infection

Fiona Senchyna  1 , Kanagavel Murugesan  1 , William Rotunno  2 , Sruti S Nadimpalli  3 , Stan Deresinski  4 , Niaz Banaei  1   2   4
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Case Reports

Sequential Treatment Failure With Aztreonam-Ceftazidime-Avibactam Followed by Cefiderocol Due to Preexisting and Acquired Mechanisms in a New Delhi Metallo-β-lactamase-Producing Escherichia coli Causing Fatal Bloodstream Infection

Fiona Senchyna et al. Clin Infect Dis. .

Abstract

We report a fatal case of New Delhi metallo-β-lactamase (NDM)-producing Escherichia coli in a bacteremic patient with sequential failure of aztreonam plus ceftazidime-avibactam followed by cefiderocol. Acquired resistance was documented phenotypically and mediated through preexisting and acquired mutations. This case highlights the need to rethink optimal treatment for NDM-producing organisms.

Keywords: New Delhi metallo-β-lactamase; avibactam; aztreonam; carbapenemase; cefiderocol.

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Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

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