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. 2024 Sep 12;13(9):874.
doi: 10.3390/antibiotics13090874.

Cefiderocol for the Treatment of Infections by VIM-Type-Producing Gram-Negative Bacteria

Cristina Kirkegaard-Biosca  1   2 , Ester Del Barrio-Tofiño  3 , Miguel Villamarín  1 , Nieves Larrosa  2   3   4 , David Campany  5 , Juan José González-López  2   3   4 , Ricard Ferrer  2   6   7 , Belén Viñado  3 , Laura Doménech  5 , Julia Sellarès-Nadal  1   2 , Laura Escolà-Vergé  2   4   8 , Nuria Fernández-Hidalgo  1   2   4 , Ibai Los-Arcos  1   2   4
Affiliations

Cefiderocol for the Treatment of Infections by VIM-Type-Producing Gram-Negative Bacteria

Cristina Kirkegaard-Biosca et al. Antibiotics (Basel). .

Erratum in

Abstract

VIM-type-producing Gram-negative bacteria (GNB) infections are difficult to treat. This is a retrospective single-center study of 34 patients who received cefiderocol for the treatment of VIM-type-producing GNB infections, including 25 Pseudomonas spp., 7 Enterobacterales, and 5 Achromobacter sp. Primary outcomes were clinical failure (defined as death, lack of clinical improvement, or a switch to another drug) at day 14 and 30-day all-cause mortality. The median age was 59 years (IQR 53.7-73.4), and the median Charlson comorbidity index was 3.5 (IQR 2-5). The main infections were respiratory tract infections (n = 9, 27%) and skin and soft tissue infections (n = 9, 27%). Eight patients exhibited bacteremia. In 9/17 patients with a drainable focus, drainage was performed. The median cefiderocol treatment duration was 13 days (IQR 8-24). Five patients (15%) experienced clinical failure on day 14, and the thirty-day mortality rate was 9/34 (27%); two cases occurred because of an uncontrolled infection source, and one was due to a new infection caused by the same bacteria. The other six deaths were unrelated to the index infection. Five patients experienced microbiological recurrence within three months. Susceptibility testing revealed the development of cefiderocol resistance in 1/7 cases with persistent or recurrent positive cultures. Cefiderocol, even in monotherapy, could be considered for the treatment of VIM-type-producing GNB infections.

Keywords: carbapenemase; extremely drug resistant; metallo-β-lactamase; multidrug resistant; siderophore.

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Conflict of interest statement

Dr. Campany, Dr. González-López and Dr. Larrosa have received honoraria for speaking at educational events by Shionogi. Dr. Rodriguez-Pardo declares there is no conflict of interest in relation to this work. Regarding other activities outside this study, D. Rodriguez-Pardo declares having received honoraria from Pfizer, Angellini, MSD and Astellas as payment for lectures, consultancy tasks and travel/accommodation for scientific purposes. I. Los-Arcos has received honoraria for speaking at educational events from MSD, Shionogi and Pfizer and has received travel support from Gilead, Shionogi, Merck and Menarini for scientific purposes. Dr. González-López declares having received honoraria from MSD as payment for lectures and educational activities. The remaining authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart representing the patient selection process.
See this image and copyright information in PMC

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