Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections

Nathaniel C Warner; Luther A Bartelt; Anne M Lachiewicz; Kathleen M Tompkins; Melissa B Miller; Kevin Alby; Melissa B Jones; Amy L Carr; Jose Alexander; Andrew B Gainey; Robert Daniels; Anna-Kathryn Burch; David E Brown; Michael J Brownstein; Faiqa Cheema; Kristin E Linder; Ryan K Shields; Sarah Longworth; David van Duin

doi:10.1093/cid/ciaa1847

Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections

Clin Infect Dis. 2021 Oct 5;73(7):e1754-e1757. doi: 10.1093/cid/ciaa1847.

Authors

Nathaniel C Warner¹, Luther A Bartelt¹, Anne M Lachiewicz¹, Kathleen M Tompkins¹, Melissa B Miller^{2

3}, Kevin Alby^{2

3}, Melissa B Jones², Amy L Carr⁴, Jose Alexander⁵, Andrew B Gainey⁶, Robert Daniels⁶, Anna-Kathryn Burch^{6

7}, David E Brown^{6

7}, Michael J Brownstein⁸, Faiqa Cheema⁹, Kristin E Linder¹⁰, Ryan K Shields^{11

12}, Sarah Longworth¹³, David van Duin¹

Affiliations

¹ Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.
² Clinical Microbiology Laboratory, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
³ Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
⁴ Department of Pharmacy, Advent Health Orlando, Orlando, Florida, USA.
⁵ Department of Microbiology/Virology/Immunology, Advent Health, Orlando, Florida, USA.
⁶ Prisma Health Children's Hospital-Midlands, Columbia, South Carolina, USA.
⁷ Department of Pediatrics, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
⁸ Adaptive Phage Therapeutics, Gaithersburg, Maryland, USA.
⁹ Division of Infectious Diseases, University of Connecticut, Farmington, Connecticut, USA.
¹⁰ Department of Pharmacy, Hartford Hospital, Hartford, Connecticut, USA.
¹¹ Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹² Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹³ Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

Treatment options for Achromobacter xylosoxidans are limited. Eight cystic fibrosis patients with A. xylosoxidans were treated with 12 cefiderocol courses. Pretreatment in vitro resistance was seen in 3 of 8 cases. Clinical response occurred after 11 of 12 treatment courses. However, microbiologic relapse was observed after 11 of 12 treatment courses, notably without emergence of resistance.

Keywords: Achromobacter xylosoxidans; cefiderocol; cystic fibrosis; lung transplantation; pneumonia.

MeSH terms

Achromobacter denitrificans*
Adult
Anti-Bacterial Agents / therapeutic use
Cefiderocol
Cephalosporins
Child
Cystic Fibrosis* / complications
Cystic Fibrosis* / drug therapy
Gram-Negative Bacterial Infections* / drug therapy
Humans

Substances

Anti-Bacterial Agents
Cephalosporins

Abstract

MeSH terms

Substances

Grants and funding