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Article Dans Une Revue Microorganisms Année : 2021

Susceptibility Testing Is Key for the Success of Cefiderocol Treatment: A Retrospective Cohort Study

Alexandre Bleibtreu
Rémy Bonnin
Hervé Dupont
Helga Junot

Résumé

Cefiderocol is a novel siderophore cephalosporin, which has proven in vitro activity against carbapenem-resistant (CR) Gram-negative pathogens and stability towards all carbapenemases. The aim of this study was to describe the first cases of prescriptions and the efficacy of cefiderocol for compassionate use in the 2 months following its access in France. We performed a national retrospective study of all patients who received at least one dose of cefiderocol from 2 November 2018 to 5 November 2019. We collected clinical characteristics and outcome through a standard questionnaire. Bacterial isolates from 12 patients were centralized and analyzed in the French National Reference Center for Antimicrobial Resistance, and sequenced using Illumina technology. Finally, 13 patients from 7 French university hospitals were included in the study. The main type of infection treated by cefiderocol was respiratory tract infections (RTI, n = 10). The targeted bacteria were Pseudomonas aeruginosa (n = 12), including carbapenemase-producing P. aeruginosa (n = 9), Acinetobacter baumannii (n = 2), Klebsiella pneumoniae (n = 1), and Enterobacter hormaechei (n = 1). Overall, of the 12 patients whose samples were analyzed, 5 P. aeruginosa strains were not susceptible to cefiderocol (4 categorized as resistant and 1 as intermediate) according to Clinical and Laboratory Standards Institute (CLSI) breakpoints. If considering susceptible strains, the cure rate was 6/7, while being 0/5 among not-susceptible strains. This study underlines the necessity to test strains in adequate conditions.
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hal-03141314 , version 1 (15-02-2021)

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Alexandre Bleibtreu, Laurent Dortet, Rémy Bonnin, Benjamin S Wyplosz, Sophie-Caroline Sacleux, et al.. Susceptibility Testing Is Key for the Success of Cefiderocol Treatment: A Retrospective Cohort Study. Microorganisms, 2021, 9 (2), pp.282. ⟨10.3390/microorganisms9020282⟩. ⟨hal-03141314⟩
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