Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 21;7(3):dlaf082.
doi: 10.1093/jacamr/dlaf082. eCollection 2025 Jun.

In vitro activity of cefiderocol against ESBL-producing and carbapenem-resistant Pseudomonas aeruginosa

Rocío Egoávil-Espejo  1 , Barbara Ymaña  1 , Rosario Oporto-Llerena  1 , Dafne Navarro  1 , Rosario Huerto-Huánuco  1 , Gina Salvador-Luján  2   3 , Tamin Ortiz-Gómez  4 , Maria Pinedo-Bardales  5 , Luciano A Palomino-Kobayashi  1 , Andrea C Gómez  4 , Angie K Castillo  1 , Patricia Gonzales  6 , Carmen Valera-Krumdieck  6 , Gabriela Soza  7 , Cristhian Zapata-Cachay  5 , Maribel Riveros  5   8   9 , Maria J Pons  1 , Joaquim Ruiz  1
Affiliations

In vitro activity of cefiderocol against ESBL-producing and carbapenem-resistant Pseudomonas aeruginosa

Rocío Egoávil-Espejo et al. JAC Antimicrob Resist. .

Abstract

Objectives: To determine the activity of cefiderocol against 101 Peruvian Pseudomonas aeruginosa isolates.

Methods: Carbapenem- and/or third- and fourth-generation cephalosporin-resistant P. aeruginosa clinical isolates were isolated in nine Peruvian health centres. Antibiotic susceptibility was established by automated methods and/or disc diffusion (10 antimicrobial agents), colistin agar test (colistin) and microdilution (cefiderocol). The presence of bla PER, bla CTX-M, bla GES, bla KPC, bla IMI, bla IMP, bla NDM, bla OXA-23, bla OXA-24, bla OXA-48, bla OXA-58, bla VIM and oprD was established by PCR; bla CTX-M and oprD were sequenced. The levels of antimicrobial resistance ranged from 20.8% (colistin) to 97.0% (meropenem).

Results: The MIC of cefiderocol ranged from ≤ 0.06 to 8 mg/L (one isolate). Cefiderocol resistance rates were 1.0% (according to the FDA and EUCAST) and 0% according to CLSI, whereas 14.9% and 1.0% of isolates were classified as cefiderocol-intermediate according to FDA and CLSI, respectively. CTX-M-131 and GES, and IMP and VIM were the most frequent ESBLs and carbapenemases, respectively. The presence of oprD mutations was tested in 47 carbapenem-resistant isolates, 23 with oprD-inactivating mutations as the sole underlying mechanism. Although no specific association was found between the presence of ESBLs and carbapenemases with cefiderocol resistance, carbapenemase-producing isolates tended to present slightly higher cefiderocol MIC values. The cefiderocol-resistant isolate did not present ESBLs or carbapenemases, showing only an oprD-inactivating mutation.

Conclusions: Cefiderocol showed excellent activity against P. aeruginosa, irrespective of the presence of ESBLs and/or carbapenemases. The high number of isolates bordering cefiderocol-resistant levels suggests the need for cautious use and continuous surveillance of this antibiotic.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Cumulative cefiderocol MIC distributions. CBP, carbapenemases.
See this image and copyright information in PMC

References

    1. Castillo AK, Espinoza K, Chaves AF et al. Antibiotic susceptibility among non-clinical Escherichia coli as a marker of antibiotic pressure in Peru (2009-2019): One Health approach. Heliyon 2022; 8: e10573. 10.1016/j.heliyon.2022.e10573 - DOI - PMC - PubMed
    1. Flores-Paredes W, Luque N, Albornoz R et al. Evolution of antimicrobial resistance levels of ESKAPE microorganisms in a Peruvian IV-level hospital. Infect Chemother 2021; 53: 449–62. 10.3947/ic.2021.0015 - DOI - PMC - PubMed
    1. Sulis G, Sayood S, Gandra S. Antimicrobial resistance in low- and middle-income countries: current status and future directions. Expert Rev Anti Infect Ther 2022; 20: 147–60. 10.1080/14787210.2021.1951705 - DOI - PubMed
    1. So M, Walti L. Challenges of antimicrobial resistance and stewardship in solid organ transplant patients. Curr Infect Dis Rep 2022; 24: 63–75. 10.1007/s11908-022-00778 - DOI - PMC - PubMed
    1. Gama ASM, Secoli SR. Self-medication practices in riverside communities in the Brazilian Amazon rainforest. Rev Bras Enferm 2020; 73: e20190432. 10.1590/0034-7167-2019-0432 - DOI - PubMed

LinkOut - more resources