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Observational Study
. 2025 Jun;44(6):1367-1374.
doi: 10.1007/s10096-025-05109-5. Epub 2025 Mar 24.

Cefiderocol treatment for patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex and Achromobacter spp.: subgroup analysis from the PERSEUS study

Julian Torre-Cisneros  1   2   3   4 , Ricard Ferrer  5 , Carmen De La Fuente Martos  1   2   6 , Jessica Sarda  7 , A Javier Gonzalez Calvo  8 , Stefano Verardi  9 , Andreas Karas  9 , Alex Soriano  2   10   11
Affiliations
Observational Study

Cefiderocol treatment for patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex and Achromobacter spp.: subgroup analysis from the PERSEUS study

Julian Torre-Cisneros et al. Eur J Clin Microbiol Infect Dis. 2025 Jun.

Abstract

Purpose: This subgroup analysis of the PERSEUS study aimed to describe the effectiveness of cefiderocol treatment in the early access programme in Spain in patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex (Bcc) or Achromobacter species.

Methods: In the retrospective, observational, multicentre PERSEUS study in Spain, the effectiveness and safety of cefiderocol treatment administered for at least 72 h up to 28 days in patients infected by Gram-negative bacteria, except Acinetobacter spp., in the early access programme was investigated. Patient demographics and baseline clinical characteristics, cefiderocol use, clinical cure at end of treatment, all-cause mortality at Day 28 were the main outcomes.

Results: A total of 20 patients had S. maltophilia infections, and 14 patients had other rare glucose non-fermenters (Bcc 8, Achromobacter spp. 5, Ralstonia mannitolilytica 1). The median (interquartile range [IQR]) age was 60.5 (48.0-65.5) years and 49.5 (33.0-59.0) years for patients with S. maltophilia and other rare non-fermenters, respectively. The majority of patients had respiratory tract infections (S. maltophilia 55%; other rare non-fermenters 71.4%), and median (IQR) duration of cefiderocol treatment was 10.0 (6.5-13.5) days and 8.0 (6-14) days, respectively. Clinical cure rates were 70%, 62.5% and 80.0% for patients with S. maltophilia, Bcc and Achromobacter spp., respectively. Corresponding 28-day all-cause mortality rates were 30.0%, 37.5% and 40.0%, respectively. One patient with R. mannitolilytica had clinical cure and survived to Day 28.

Conclusions: Cefiderocol is an important addition to the limited treatment options for patients infected by these rare glucose non-fermenting Gram-negative bacteria.

Trial registration: ClinicalTrials.gov: NCT05789199 (Registration date: 16 February 2023).

Keywords: Achromobacter spp; Burkholderia cepacia complex; Stenotrophomonas maltophilia; Cefiderocol; Non-fermenting Gram-negative bacteria.

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Conflict of interest statement

Declarations. Ethics approval: The study was approved by the institutional review board of Hospital La Princesa, Madrid, on 3 November 2020 (Royal Decree 957/2020), which served as central reference ethics committee. The study was compliant with all legal and regulatory requirements, the International Conference on Harmonisation Good Clinical Practice E6 guidelines and the Declaration of Helsinki. Consent to participate: In accordance with Spanish regulations, patient consent was waived due to the retrospective design of the study as patients completed their treatment prior to study initiation; therefore, the study represented no harm for the participants. Consent to publish: Not applicable. Competing interests: Julian Torre-Cisneros has received educational grants and fee for advisory activities from Shionogi, Pfizer, MSD, Menarini; and unrestricted research grants from Pfizer and MSD. Alex Soriano has received honoraria for lectures and advisory boards from Shionogi, Pfizer, Menarini, Angelini, Advance Pharma and Gilead, and grants from Pfizer and Gilead. Ricard Ferrer has received honoraria for lectures from Gilead, Menarini, MSD, Shionogi, and ThermoFisher; consulting fees from Cytosorbent, Inoterm, and Pfizer; and holds stocks or stock options from Grifols. Carmen De La Fuente Martos received honoraria from Shionogi & Co., Ltd., Osaka, Japan, for participation in this study. Jessica Sarda, A. Javier Gonzalez Calvo, Stefano Verardi, Andreas Karas are employees of Shionogi.

References

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