0aaf005a2cc2463539c4446228ab2a12 pmc_11428964.pdf aef64eed38ce8f9778c56b471e955820a484401a pmc_11428964.pdf 23cbfc9c03da868ee067592bde82c9224a823f902cfe428b681ad6171b53b66b pmc_11428964.pdf Title: Cefiderocol for the Treatment of Infections by VIM-Type-Producing Gram-Negative Bacteria Subject: VIM-type-producing Gram-negative bacteria (GNB) infections are difficult to treat. This is a retrospective single-center study of 34 patients who received cefiderocol for the treatment of VIM-type-producing GNB infections, including 25 Pseudomonas spp., 7 Enterobacterales, and 5 Achromobacter sp. Primary outcomes were clinical failure (defined as death, lack of clinical improvement, or a switch to another drug) at day 14 and 30-day all-cause mortality. The median age was 59 years (IQR 53.7–73.4), and the median Charlson comorbidity index was 3.5 (IQR 2–5). The main infections were respiratory tract infections (n = 9, 27%) and skin and soft tissue infections (n = 9, 27%). Eight patients exhibited bacteremia. In 9/17 patients with a drainable focus, drainage was performed. The median cefiderocol treatment duration was 13 days (IQR 8–24). Five patients (15%) experienced clinical failure on day 14, and the thirty-day mortality rate was 9/34 (27%); two cases occurred because of an uncontrolled infection source, and one was due to a new infection caused by the same bacteria. The other six deaths were unrelated to the index infection. Five patients experienced microbiological recurrence within three months. Susceptibility testing revealed the development of cefiderocol resistance in 1/7 cases with persistent or recurrent positive cultures. Cefiderocol, even in monotherapy, could be considered for the treatment of VIM-type-producing GNB infections. Keywords: metallo–lactamase; siderophore; multidrug resistant; extremely drug resistant;carbapenemase Author: Cristina Kirkegaard-Biosca, Ester del Barrio-Tofiño, Miguel Villamarín, Nieves Larrosa, David Campany, Juan José González-López, Ricard Ferrer, Belén Viñado, Laura Doménech, Julia Sellarès-Nadal, Laura Escolà-Vergé, Nuria Fernández-Hidalgo and Ibai Los-Arcos Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Sep 12 11:54:46 2024 CEST ModDate: Thu Sep 12 11:59:18 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 580541 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ETLENW+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 CAMXTK+EURM10 Type 1 Builtin yes yes yes 16 0 KHSBWK+URWPalladioL-Bold Type 1 Custom yes yes yes 21 0 TIPDUS+URWPalladioL-Roma Type 1 Custom yes yes yes 27 0 GXIHFY+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 XQKSOB+VnURWPalladioL Type 1 Custom yes yes yes 37 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 54 0 IKKWKP+CMSY10 Type 1 Builtin yes yes yes 71 0 CBOJLE+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 82 0 CBOJME+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 88 0 CBOJMF+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 94 0 CBOJMG+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 100 0 CBOJMH+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 103 0 CBOJMI+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 106 0 CBOKBI+PalatinoLinotype-Roman TrueType MacRoman yes yes no 109 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 116 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-02-06 02:47:59 CET RepresentationInformation: pmc_11428964.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-01-15 02:36:45 CET Size: 580541 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 245 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methods Destination: section.2 Children: Item: Title: Definitions and Outcomes Destination: subsection.2.1 Item: Title: Microbiological Methods Destination: subsection.2.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.5 Info: Title: Cefiderocol for the Treatment of Infections by VIM-Type-Producing Gram-Negative Bacteria Author: Cristina Kirkegaard-Biosca, Ester del Barrio-Tofiño, Miguel Villamarín, Nieves Larrosa, David Campany, Juan José González-López, Ricard Ferrer, Belén Viñado, Laura Doménech, Julia Sellarès-Nadal, Laura Escolà-Vergé, Nuria Fernández-Hidalgo and Ibai Los-Arcos Subject: VIM-type-producing Gram-negative bacteria (GNB) infections are difficult to treat. This is a retrospective single-center study of 34 patients who received cefiderocol for the treatment of VIM-type-producing GNB infections, including 25 Pseudomonas spp., 7 Enterobacterales, and 5 Achromobacter sp. Primary outcomes were clinical failure (defined as death, lack of clinical improvement, or a switch to another drug) at day 14 and 30-day all-cause mortality. The median age was 59 years (IQR 53.7 73.4), and the median Charlson comorbidity index was 3.5 (IQR 2 5). The main infections were respiratory tract infections (n = 9, 27%) and skin and soft tissue infections (n = 9, 27%). Eight patients exhibited bacteremia. In 9/17 patients with a drainable focus, drainage was performed. The median cefiderocol treatment duration was 13 days (IQR 8 24). Five patients (15%) experienced clinical failure on day 14, and the thirty-day mortality rate was 9/34 (27%); two cases occurred because of an uncontrolled infection source, and one was due to a new infection caused by the same bacteria. The other six deaths were unrelated to the index infection. Five patients experienced microbiological recurrence within three months. Susceptibility testing revealed the development of cefiderocol resistance in 1/7 cases with persistent or recurrent positive cultures. Cefiderocol, even in monotherapy, could be considered for the treatment of VIM-type-producing GNB infections. 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