An assessment of cefiderocol's synergistic effects with eravacycline, colistin, meropenem, levofloxacin, ceftazidime/avibactam, and tobramycin against carbapenem-resistant and-susceptible<i> Pseudomonas</i><i> aeruginosa</i>

Mataracı-Kara E., Özer B., Yılmaz M., Özbek-Çelik B.

MICROBIAL PATHOGENESIS, cilt.204, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 204
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.micpath.2025.107560
  • Dergi Adı: MICROBIAL PATHOGENESIS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, Environment Index, Food Science & Technology Abstracts, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: Carbapenem-resistant, Cefiderocol, Combination, Pseudomonas aeruginosa, Synergy
  • İstanbul Üniversitesi Adresli: Hayır

Özet

Objectives: This research examines the combined in vitro effectiveness of cefiderocol with other antibiotics against carbapenem-resistant and-susceptible Pseudomonas aeruginosa obtained from Intensive Care Units. Methods: Forty unique P. aeruginosa isolates were evaluated for their minimum inhibitory concentrations (MICs) using broth microdilution. All the isolates were evaluated for carbapenemase resistance genes. The bactericidal and synergistic effects of cefiderocol, alone or in conjunction with other antimicrobials, were assessed using time-kill curve experiments. Results: Colistin had the lowest MIC50/MIC90 value of 1/2 mg/L, with cefiderocol following at 0.5/4 mg/L against the tested strains. Cefiderocol, levofloxacin, tobramycin, and meropenem showed bactericidal activity against various isolates. In carbapemase-producing P. aeruginosa strains, almost half of them were carrying blaVIM. Moreover, the most effective synergistic interactions were seen with combinations of cefiderocol and eravacycline, cefiderocol and meropenem, and cefiderocol and levofloxacin against four out of eight strains at 1xMIC concentrations after 24 h. Additionally, we observed synergistic effects when cefiderocol was used with colistin, tobramycin, and ceftazidime/avibactam against three of the eight isolates. Antagonism against the analyzed P. aeruginosa strains was not found. Conclusion: The findings of this study indicate that combining cefiderocol enhances its synergistic efficacy against both carbapenem-resistant and susceptible P. aeruginosa strains. This suggests that combination therapy could serve as a potential alternative for treating resistant P. aeruginosa infections.