Successful treatment of sepsis caused by multidrug-resistant Pseudomonas aeruginosa using cefi derocol in an immunocompromised hematological cancer patient fol lowing allogeneic hematopoietic stem cell transplantation

Czech version

Authors: M. Navrátil
Authors‘ workplace: Klinika hematoonkologie LF OU a FN Ostrava
Published in: Klin Onkol 2025; 38(3): 209-212
Category: Case Reports
doi: https://doi.org/10.48095/ccko2025209

Overview

Background: In present days we have the possibility to use new antibiotic drug cefiderocol for the treatment of multiple drug resistant bacterial infections. This infections are the result of preceding and repeating antibiotic therapy mainly in immunocompromised patients. Case: In our case report we present a young woman with acute leukemia with complicated infection in the perianal and rectal area with sepsis development caused by Pseudomonas aeruginosa with lower sensitivity for carbapenems at the early time of allogeneic transplantation of hematopoiesis due to acute leukemia, when she is under the negative influence of chemotherapy and immunosuppressive drugs. We emphasize the adverse effects of colimycine type antibiotics and their interactions with other drugs with the organ toxicity development. Conclusion: The newly available antibiotic cefiderocol with low potential of adverse events and drug interactions demonstrates a benefit in the treatment of the patient described.

Keywords:

Pseudomonas aeruginosa – sepsis – cefiderocol

Sources

1. Bassetti M, Echols R, Matsunaga Y et al. Efficacy and safety of cefiderocol or best available therapy for the treatment of serious infections caused by carbapenem-resistant Gram-negative bacteria (CREDIBLE--CR): a randomised, open-label, multicentre, pathogen-focused, descriptive, phase 3 trial. Lancet Infect Dis 2021; 21 (2): 226–240. doi: 10.1016/S1473-3099 (20) 30796-9.

2. Sato T, Yamawaki K. Cefiderocol: Discovery, chemistry, and in vivo profiles of a novel siderophore cephalosporin. Clin Infect Dis 2019; 69 (Suppl 7): S538–S543. doi: 10.1093/cid/ciz826.

3. Zhanel GG, Golden AR, Zelenitsky S et al. Cefiderocol: a siderophore cephalosporin with activity against carbapenem-resistant and multidrug-resistant gram-negative bacilli. Drugs. 2019; 79 (3): 271–289. doi: 10.1007/s40265-019-1055-2.

4. Lasarte-Monterrubio C, Fraile-Ribot PA, Vázquez-Ucha JC et al. Activity of cefiderocol, imipenem/relebactam, cefepime/taniborbactam and cefepime/zidebactam against ceftolozane/tazobactam- and ceftazidime/avibactam-resistant Pseudomonas aeruginosa. J Antimicrob Chemother 2022; 77 (10): 2809–2815. doi: 10.1093/jac/dkac241.

5. Santerre Henriksen A, Jeannot K, Oliver A et al. In vitro activity of cefiderocol against European Pseudomonas aeruginosa and Acinetobacter spp., including isolates resistant to meropenem and recent b-lactam/b-lactamase inhibitor combinations. Microbiol Spectr 2024; 12 (4): e0383623. doi: 10.1128/spectrum.03836-23.

6. Teran N, Egge SL, Phe K et al. The emergence of cefiderocol resistance in Pseudomonas aeruginosa from a heteroresistant isolate during prolonged therapy. Antimicrob Agents Chemother 2024; 68 (1): e0100923. doi: 10.1128/aac.01009-23.