title: Activity of cefiderocol (S-649266) against carbapenem-resistant Gram-negative bacteria collected from inpatients in Greek hospitals.
abstract: Cefiderocol (S-649266), a siderophore cephalosporin, utilizes a novel mechanism of entry into the periplasmic space of Gram-negative bacteria and is broadly stable to ESBLs and carbapenemases.
  
  
  
  A collection of carbapenem-resistant Gram-negative bacteria isolated from clinical specimens in 18 Greek hospitals was tested for susceptibility to cefiderocol, meropenem, ceftazidime, cefepime, ceftazidime/avibactam, ceftolozane/tazobactam, aztreonam, amikacin, ciprofloxacin, colistin and tigecycline. Broth microdilution plates were used to determine MICs.
  
  
  
  In total 189 non-fermentative Gram-negative bacteria (107 Acinetobacter baumannii and 82 Pseudomonas aeruginosa ) and 282 Enterobacteriaceae (including 244 Klebsiella pneumoniae , 14 Enterobacter cloacae and 11 Providencia stuartii ) were studied. For both A. baumannii and P. aeruginosa the MIC 90 of cefiderocol was 0.5 mg/L. For K. pneumoniae , E. cloacae and P. stuartii the MIC 90 of cefiderocol was 1, 1 and 0.5 mg/L, respectively. Tigecycline was the second most active antibiotic, followed by colistin.
  
  
  
  Cefiderocol exhibited greater antimicrobial activity in vitro against carbapenem-resistant Gram-negative bacteria than comparator antibiotics.
authors.affiliation: Research Center of Infectious Diseases, Iaso Group Hospitals, Athens, Greece.|Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
authors.affiliation: Research Center of Infectious Diseases, Iaso Group Hospitals, Athens, Greece.|Central Laboratories, Iaso Group Hospitals, Athens, Greece.
authors.forename: Tilemachos
authors.initials: T
authors.lastname: Skalidis
authors.affiliation: Research Center of Infectious Diseases, Iaso Group Hospitals, Athens, Greece.|Department of Medicine-Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece.
authors.forename: Konstantinos Z
authors.initials: KZ
authors.lastname: Vardakas
authors.affiliation: Research Center of Infectious Diseases, Iaso Group Hospitals, Athens, Greece.|Central Laboratories, Iaso Group Hospitals, Athens, Greece.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Legakis
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000378:metabolism; D015780:Carbapenems / Q000494:pharmacology*; D000077723:Cefepime; D002442:Ceftazidime / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007297:Inpatients; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D013845:Thienamycins / Q000494:pharmacology; D000078304:Tigecycline; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism; D000097602:Cefiderocol
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D000077723:Cefepime; D002442:Ceftazidime; D002511:Cephalosporins; D003091:Colistin; D000077731:Meropenem; D008911:Minocycline; D013845:Thienamycins; D000078304:Tigecycline; D001618:beta-Lactamases; D000097602:Cefiderocol; C063912:carbapenemase