Rapid development of cefiderocol resistance in a carbapenem-resistant Pseudomonas aeruginosa isolate associated with mutations in the pyoverdine biosynthesis pathway
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..
Here we report the in vivo development of cefiderocol resistance within 11 days after therapy initiation in a critically ill patient with bloodstream infection, infection of peri-anal fistula, and pneumonia caused by a VIM-2 harbouring, carbapenem-resistant Pseudomonas aeruginosa. Compared to a cefiderocol-naïve P. aeruginosa blood culture isolate, agar diffusion susceptibility testing found a reduced cefiderocol inhibition zone diameter in a P. aeruginosa recovered from peri-anal abscess tissue cultures after initiation of cefiderocol therapy. Subsequent whole-genome sequencing suggested that both isolates were of clonal origin. Comparison of genomes found an accumulation of missense mutations within pvdP, pvdE, pvdJ, and pvdD (i.e. genes associated with biosynthesis of pyoverdine), the main siderophore produced by P. aeruginosa. Quantification of pyoverdine production under iron-depleted conditions showed a significantly (P = 0.0003) higher pyoverdine production by the cefiderocol-resistant isolate. While pyoverdine quantity alone appears not to be decisive for cefiderocol resistance, the reported case highlights the potentially rapid emergence of cefiderocol resistance in P. aeruginosa and points towards a potential involvement of iron up-take systems in this process.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Journal of global antimicrobial resistance - 34(2023) vom: 08. Sept., Seite 59-62 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Brakert, Luise [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 11.09.2023 Date Revised 13.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jgar.2023.06.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358811732 |
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| 520 | |a Here we report the in vivo development of cefiderocol resistance within 11 days after therapy initiation in a critically ill patient with bloodstream infection, infection of peri-anal fistula, and pneumonia caused by a VIM-2 harbouring, carbapenem-resistant Pseudomonas aeruginosa. Compared to a cefiderocol-naïve P. aeruginosa blood culture isolate, agar diffusion susceptibility testing found a reduced cefiderocol inhibition zone diameter in a P. aeruginosa recovered from peri-anal abscess tissue cultures after initiation of cefiderocol therapy. Subsequent whole-genome sequencing suggested that both isolates were of clonal origin. Comparison of genomes found an accumulation of missense mutations within pvdP, pvdE, pvdJ, and pvdD (i.e. genes associated with biosynthesis of pyoverdine), the main siderophore produced by P. aeruginosa. Quantification of pyoverdine production under iron-depleted conditions showed a significantly (P = 0.0003) higher pyoverdine production by the cefiderocol-resistant isolate. While pyoverdine quantity alone appears not to be decisive for cefiderocol resistance, the reported case highlights the potentially rapid emergence of cefiderocol resistance in P. aeruginosa and points towards a potential involvement of iron up-take systems in this process | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Blood stream infection | |
| 650 | 4 | |a Cefiderocol | |
| 650 | 4 | |a Multidrug resistance | |
| 650 | 4 | |a Non-susceptbility | |
| 650 | 4 | |a Pseudomonas aeruginosa | |
| 650 | 4 | |a Pyoverdine biosynthesis | |
| 650 | 4 | |a Stem cell transplantation | |
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| 650 | 7 | |a Carbapenems |2 NLM | |
| 700 | 1 | |a Berneking, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Both, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Berinson, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Jiabin |e verfasserin |4 aut | |
| 700 | 1 | |a Aepfelbacher, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Wolschke, Christine |e verfasserin |4 aut | |
| 700 | 1 | |a Wichmann, Dominic |e verfasserin |4 aut | |
| 700 | 1 | |a Rohde, Holger |e verfasserin |4 aut | |
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