Treatment-emergent cefiderocol resistance in carbapenem-resistant Acinetobacter baumannii is associated with insertion sequence IS Aba36 in the siderophore receptor pirA

We report the emergence of cefiderocol resistance in a carbapenem-resistant isolate from a sacral decubitus ulcer. Cefiderocol was initially used; however, a newly approved sulbactam-durlobactam therapy with source control and flap coverage was successful in treating the infection. Laboratory invest...

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Bibliographic Details
Published in:	Antimicrobial agents and chemotherapy Vol. 68; no. 7; p. e0029024
Main Authors:	Huang, En, Thompson, Rebekah N, Moon, Sun Hee, Keck, Jacob M, Lowry, Michael S, Melero, Joe, Jun, Se-Ran, Rosenbaum, Eric R, Dare, Ryan K
Format:	Journal Article
Language:	English
Published:	United States 09-07-2024
Subjects:	Acinetobacter baumannii - drug effects Acinetobacter baumannii - genetics Acinetobacter Infections - drug therapy Acinetobacter Infections - microbiology Anti-Bacterial Agents - pharmacology Azabicyclo Compounds - pharmacology Bacterial Outer Membrane Proteins Carbapenems - pharmacology Cefiderocol Cephalosporins - pharmacology DNA Transposable Elements - genetics Drug Resistance, Multiple, Bacterial - genetics Humans Male Microbial Sensitivity Tests Receptors, Cell Surface - genetics Receptors, Cell Surface - metabolism Sulbactam - pharmacology cefiderocol sulbactam-durlobactam Acinetobacter baumannii ISAba36 carbapenem resistance OXA-72
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Summary:	We report the emergence of cefiderocol resistance in a carbapenem-resistant isolate from a sacral decubitus ulcer. Cefiderocol was initially used; however, a newly approved sulbactam-durlobactam therapy with source control and flap coverage was successful in treating the infection. Laboratory investigation revealed cefiderocol resistance mediated by IS insertion into the siderophore receptor .
ISSN:	1098-6596
DOI:	10.1128/aac.00290-24