Polati Vishnu Rao, Gattu Santosh, Maturu Venkata Nagarjuna, Prakasham P Swati, Maqsood Maryam
Department of Infectious Diseases, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India.
Department of Pulmonology, Yashoda Hospitals, Hyderabad, Telangana, India.
Eur J Clin Microbiol Infect Dis. 2025 Jun;44(6):1349-1355. doi: 10.1007/s10096-025-05106-8. Epub 2025 Mar 18.
Treatment option for the infections caused by MBL-producing P. aeruginosa is severely limited. Cefepime/zidebactam (WCK 5222) is a novel β-lactam/ β-lactam-enhancer combination, currently in global Phase 3 clinical development. It is reported to show a broad-spectrum in vitro activity and translational efficacy in non-clinical PK/PD models against carbapenem-resistant Gram-negative bacteria including MBL-producing P. aeruginosa. We present a case of a 13-year-old girl, suffering from tuberculosis with a refractory lung empyema caused by NDM-producing, XDR P. aeruginosa who did not respond to several rounds of colistin or aztreonam plus ceftazidime/avibactam therapies albeit effective source control, over 4 months period.
The infecting organism was found to be susceptible to cefepime/zidebactam. After obtaining informed consent and necessary approvals, the patient was treated under compassionate ground.
The patient was treated with adult dose regimen of cefepime/zidebactam (due to higher body weight) for 21 days that led to clinical and microbiological cure.
This case highlights both severity of the antimicrobial resistance and hope offered by an under-trial novel antibiotic.
由产金属β-内酰胺酶（MBL）的铜绿假单胞菌引起的感染，其治疗选择极为有限。头孢吡肟/齐他西克（WCK 5222）是一种新型的β-内酰胺/β-内酰胺增强剂组合，目前正处于全球3期临床开发阶段。据报道，它在体外对包括产MBL的铜绿假单胞菌在内的耐碳青霉烯革兰氏阴性菌具有广谱活性，并且在非临床药代动力学/药效学（PK/PD）模型中具有转化疗效。我们报告了一例13岁女孩的病例，她患有结核病，并伴有由产新德里金属β-内酰胺酶（NDM）的广泛耐药（XDR）铜绿假单胞菌引起的难治性肺脓肿，尽管进行了有效的源头控制，但在4个多月的时间里，对几轮黏菌素或氨曲南加头孢他啶/阿维巴坦治疗均无反应。
发现感染菌对头孢吡肟/齐他西克敏感。在获得知情同意并得到必要批准后，患者在同情用药的情况下接受了治疗。
患者接受了成人剂量方案的头孢吡肟/齐他西克治疗（由于体重较高），为期21天，实现了临床和微生物学治愈。
该病例既凸显了抗菌药物耐药性的严重性，也展示了一种尚在试验中的新型抗生素带来的希望。
