Evolution of Cefiderocol Non-Susceptibility in Pseudomonas aeruginosa in a Patient Without Previous Exposure to the Antibiotic

We report the emergence of non-susceptibility to cefiderocol from a subpopulation of Pseudomonas aeruginosa recovered from a patient without history of cefiderocol exposure. Whole genome sequencing identified mutations in major iron transport pathways previously associated with cefiderocol uptake. Susceptibility testing should be performed before therapy with siderophore cephalosporins.

Automated summary

A study reported the emergence of non-susceptibility to cefiderocol in a subpopulation of Pseudomonas aeruginosa recovered from a patient without prior exposure to the antibiotic. Whole genome sequencing revealed mutations in major iron transport pathways linked to cefiderocol uptake, highlighting the importance of susceptibility testing before therapy with siderophore cephalosporins.