1887

Abstract

In cystic fibrosis (CF) patients, Gram-negative complex (Bcc) infections are associated with recurrent pulmonary exacerbations. Bcc organisms are innately resistant to many antibiotics, and infection with is a contraindication to lung transplantation. We report a CF patient with severe lung disease, colonized with Bcc, with a history of around nine exacerbations per year for over 10 years, for whom antibiotic regimens (including targeted and broad-spectrum antibiotics) had not cleared infection or extended the interval between exacerbations. After receiving a 2 week cefiderocol-containing regimen, the patient remained stable for more than 5 months without the need for additional antibiotics or hospital admissions for respiratory exacerbations.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000413
2022-10-07
2024-05-17
Loading full text...

Full text loading...

/deliver/fulltext/acmi/4/10/acmi000413.html?itemId=/content/journal/acmi/10.1099/acmi.0.000413&mimeType=html&fmt=ahah

References

  1. Lord R, Jones AM, Horsley A. Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation. Cochrane Database Syst Rev 2020; 4:CD009529 [View Article]
    [Google Scholar]
  2. Jin Y, Zhou J, Zhou J, Hu M, Zhang Q et al. Genome-based classification of Burkholderia cepacia complex provides new insight into its taxonomic status. Biol Direct 2020; 15:6 [View Article]
    [Google Scholar]
  3. Horsley A, Jones AM, Lord R. Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation. Cochrane Database Syst Rev 2016CD009529 [View Article] [PubMed]
    [Google Scholar]
  4. Horsley A, Webb K, Bright-Thomas R, Govan J, Jones A. Can early Burkholderia cepacia complex infection in cystic fibrosis be eradicated with antibiotic therapy?. Front Cell Infect Microbiol 2011; 1:18 [View Article]
    [Google Scholar]
  5. Regan KH, Bhatt J. Eradication therapy for Burkholderia cepacia complex in people with cystic fibrosis. Cochrane Database Syst Rev 2019; 4:CD009876 [View Article]
    [Google Scholar]
  6. Trust CF. UK cystic fibrosis registry annual data report 2019; 2019 https://www.cysticfibrosis.org.uk/the-work-we-do
  7. Jones AM, Dodd ME, Govan JRW, Barcus V, Doherty CJ et al. Burkholderia cenocepacia and Burkholderia multivorans: influence on survival in cystic fibrosis. Thorax 2004; 59:948–951 [View Article] [PubMed]
    [Google Scholar]
  8. France MW, Dodd ME, Govan JR, Doherty CJ, Webb AK et al. The changing epidemiology of Burkholderia species infection at an adult cystic fibrosis centre. J Cyst Fibros 2008; 7:368–372 [View Article] [PubMed]
    [Google Scholar]
  9. Drevinek P, Mahenthiralingam E. Burkholderia cenocepacia in cystic fibrosis: epidemiology and molecular mechanisms of virulence. Clin Microbiol Infect 2010; 16:821–830 [View Article] [PubMed]
    [Google Scholar]
  10. Zlosnik JEA, Zhou G, Brant R, Henry DA, Hird TJ et al. Burkholderia species infections in patients with cystic fibrosis in British Columbia, Canada. 30 years’ experience. Ann Am Thorac Soc 2015; 12:70–78 [View Article]
    [Google Scholar]
  11. Belcher R, Zobell JT. Optimization of antibiotics for cystic fibrosis pulmonary exacerbations due to highly resistant nonlactose fermenting Gram negative bacilli: meropenem-vaborbactam and cefiderocol. Pediatr Pulmonol 2021; 56:3059–3061 [View Article] [PubMed]
    [Google Scholar]
  12. Gavioli EM, Guardado N, Haniff F, Deiab N, Vider E. Does cefiderocol have a potential role in cystic fibrosis pulmonary exacerbation management?. Microb Drug Resist 2021; 27:1726–1732 [View Article]
    [Google Scholar]
  13. Cefiderocol. Cefidericol summary of product characteristics. n.d https://www.medicines.org.uk/emc/product/11771#gref
  14. Bassetti M, Echols R, Matsunaga Y, Ariyasu M, Doi 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; 21:226–240 [View Article]
    [Google Scholar]
  15. Shionogi Shionogi data on file (cefiderocol compassionate use programme-unpublished); 2022
  16. Warner NC, Bartelt L, Lachiewicz A, Lachiewicz A, Tompkins KM et al. 730. Cefiderocol for the treatment of Achromobacter xylosoxidans infections in two lung transplant patients with cystic fibrosis. Open Forum Infect Dis 2019; 6:S326–S327 [View Article]
    [Google Scholar]
  17. Warner NC, Bartelt LA, Lachiewicz AM et al. Cefiderocol for the treatment of adult and pediatric patients with cystic fibrosis and Achromobacter xylosoxidans infections. Clin Infect Dis 2020
    [Google Scholar]
  18. Gainey AB, Burch A-K, Brownstein MJ, Brown DE, Fackler J et al. Combining bacteriophages with cefiderocol and meropenem/vaborbactam to treat a pan-drug resistant Achromobacter species infection in a pediatric cystic fibrosis patient. Pediatr Pulmonol 2020; 55:2990–2994 [View Article] [PubMed]
    [Google Scholar]
  19. Firoz A, Haris M, Hussain K, Raza M, Verma D et al. Can targeting iron help in combating chronic Pseudomonas infection? A systematic review. Cureus 2021; 13:e13716 [View Article]
    [Google Scholar]
  20. Burnard D, Robertson G, Henderson A, Falconer C, Bauer MJ et al. Burkholderia pseudomallei clinical isolates are highly susceptible in vitro to cefiderocol, a siderophore cephalosporin. Antimicrob Agents Chemother 2021; 65:e00685-20 [View Article]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000413
Loading
/content/journal/acmi/10.1099/acmi.0.000413
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error