Didwania Akansha, Mohapatra Sarita, Kocher Deepak, Gautam Hitender, Kumari Priyanka, Kumar Arvind, Soneja Manish, Vikram Naval K, Sood Seema, Dhawan Benu, Das Bimal Kumar, Chaudhry Rama, Mahapatra Manoranjan, Wig Naveet, Kapil Arti
Infectious Diseases, Department of Medicine and Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Med Microbiol. 2025 Mar-Apr;54:100793. doi: 10.1016/j.ijmmb.2025.100793. Epub 2025 Jan 31.
Cefiderocol is a parenteral catechol-type siderophore cephalosporin, which has been approved for the treatment of Gram-negative bacterial infections. Its activity among the carbapenem-resistant Gram-negative bacilli (CR-GNBs) in India is largely unknown.
We tested in-vitro susceptibility of cefiderocol in 84 CR-GNB [ carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Escherichia coli (CREC) and carbapenem-resistant Klebsiella pneumoniae (CRKP)] by broth microdilution (BMD) and disc diffusion (DD) using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints and concordance of DD was compared with BMD. Cefiderocol susceptibility was evaluated based on the presence of bla and bla genes.
Following CLSI and EUCAST breakpoints, 76.2% [CRKP: 95.65% (22/23); CRPA: 80% (16/20); CREC: 65% (13/20); CRAB: 61.9% (13/21)] and 52.3% [ CRKP: 82.6% (19/23); CRPA: 50% (10/20); CREC: 20% (4/20)] of CR-GNBs were observed susceptible to cefiderocol, respectively. The susceptibility to cefiderocol was seen higher with lower MIC and MIC values for CRKP [1 μg/ml; 4 μg/ml ] and CRPA [2 μg/ml; 8 μg/ml ] in comparison to the other two groups of organisms. The categorical agreement between BMD and DD was found between 90% and 100% for all organisms. Cefiderocol susceptibility among the isolates harbouring bla, bla, and both bla and bla genes was observed 75% (24/32); 100% (3/3); and 66.6% (4/6), respectively.
Cefiderocol demonstrated high in-vitro activity against CRKP and CRPA isolates from India with lower MIC and MIC irrespective of the presence of bla and bla genes.
头孢地尔是一种肠外注射用儿茶酚型铁载体头孢菌素，已被批准用于治疗革兰氏阴性菌感染。其在印度耐碳青霉烯类革兰氏阴性杆菌（CR - GNBs）中的活性尚不清楚。
我们采用肉汤微量稀释法（BMD）和纸片扩散法（DD），依据临床和实验室标准协会（CLSI）以及欧洲抗菌药物敏感性试验委员会（EUCAST）的断点，检测了84株CR - GNB（耐碳青霉烯类鲍曼不动杆菌（CRAB）、耐碳青霉烯类铜绿假单胞菌（CRPA）、耐碳青霉烯类大肠埃希菌（CREC）和耐碳青霉烯类肺炎克雷伯菌（CRKP））对头孢地尔的体外敏感性，并将DD与BMD的一致性进行了比较。基于bla和bla基因的存在情况评估头孢地尔的敏感性。
按照CLSI和EUCAST断点，分别有76.2%[CRKP：95.65%（22/23）；CRPA：80%（16/20）；CREC：65%（13/20）；CRAB：61.9%（13/21）]和52.3%[CRKP：82.6%（19/23）；CRPA：50%（10/20）；CREC：20%（4/20）]的CR - GNBs对头孢地尔敏感。与其他两组菌株相比，CRKP[1μg/ml；4μg/ml]和CRPA[2μg/ml；8μg/ml]对头孢地尔的敏感性在较低的最低抑菌浓度（MIC）和最低杀菌浓度（MIC）时更高。所有菌株的BMD和DD之间的分类一致性在90%至100%之间。在携带bla、bla以及同时携带bla和bla基因的分离株中，头孢地尔的敏感性分别为75%（24/32）、100%（3/3）和66.6%（4/6）。
无论是否存在bla和bla基因，头孢地尔对来自印度分离的CRKP和CRPA菌株均表现出较高的体外活性，且MIC和MIC较低。
