Clinical Microbiology Unit, Pasteur Institute of Lille, Lille, France.
European Institute for Emerging Antibiotic Resistance, Pasteur Institute, Lille, France.
J Clin Microbiol. 2023 Jul 20;61(7):e0188322. doi: 10.1128/jcm.01883-22. Epub 2023 Jun 20.
Cefiderocol (FDC) is a siderophore cephalosporin with a broad spectrum of activity against many multidrug-resistant Gram-negative bacteria. Acquired resistance to FDC has been already reported among Gram-negative isolates, thus highlighting the need for rapid and accurate identification of such resistant pathogens, in order to control their spread. Therefore, the SuperFDC medium was developed to screen FDC-resistant , Pseudomonas aeruginosa, and Acinetobacter baumannii. After testing several culture conditions, a selective medium was set up by supplementing an iron-depleted agar medium with 8 μg/mL of FDC and evaluated with a collection of 68 FDC-susceptible and 33 FDC-resistant Gram-negative isolates exhibiting a variety of β-lactam resistance mechanisms. The sensitivity and specificity of detection of this medium were evaluated at 97% and 100%, respectively. In comparison with the reference broth microdilution method, only 3% very major errors were found. In addition, excellent detection performances were obtained by testing spiked stools with a lower limit of detection ranging between 10 and 10 CFU/mL. The SuperFDC medium allows detection of FDC-resistant Gram-negative isolates regardless of their corresponding resistance mechanisms.
头孢他啶美罗培南（FDC）是一种具有广谱活性的新型含β-内酰胺酶抑制剂的广谱头孢菌素，可用于治疗多种多重耐药革兰氏阴性菌感染。目前已经报道了一些革兰氏阴性菌对 FDC 的获得性耐药，因此，需要快速、准确地识别此类耐药病原体，以控制其传播。因此，开发了 SuperFDC 培养基来筛选 FDC 耐药的铜绿假单胞菌和鲍曼不动杆菌。在测试了几种培养条件后，通过在缺铁琼脂培养基中添加 8μg/ml 的 FDC 来设置选择性培养基，并使用 68 株 FDC 敏感和 33 株 FDC 耐药的革兰氏阴性菌分离株进行评估，这些分离株表现出多种β-内酰胺耐药机制。该培养基的检测灵敏度和特异性分别为 97%和 100%。与参考肉汤微量稀释法相比，仅发现 3%的非常大误差。此外，通过检测含 10-10 CFU/ml 下限的粪便标本，该培养基也表现出了良好的检测性能。SuperFDC 培养基可用于检测 FDC 耐药的革兰氏阴性菌，无论其相应的耐药机制如何。
