Successful Use of Cefepime-Zidebactam (WCK 5222) as a Salvage Therapy for the Treatment of Disseminated Extensively Drug-Resistant New Delhi Metallo-β-Lactamase-Producing Pseudomonas aeruginosa Infection in an Adult Patient with Acute T-Cell Leukemia

Antimicrob Agents Chemother. 2023 Jun 14;67(8):e0050023. doi: 10.1128/aac.00500-23. Online ahead of print.

Abstract

With limited and often toxic treatment options, carbapenem-resistant Gram-negative infections are associated with significant mortality. Cefepime-zidebactam is a promising antibiotic option undergoing a phase 3 trial that has activity against diverse antibiotic-resistant mechanisms in Gram-negative pathogens due to its β-lactam enhancer mechanism, mediating multiple PBP binding. We report a case of disseminated infection caused by a New Delhi metallo-β-lactamase-producing, extensively drug-resistant Pseudomonas aeruginosa isolate in a patient with acute T-cell leukemia, successfully managed with cefepime-zidebactam as a salvage therapy.

Keywords: WCK 5222; XDR Pseudomonas aeruginosa; cefepime-zidebactam; disseminated infections; drug resistance; metallo-β-lactamase; polymyxins; salvage therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Azabicyclo Compounds / therapeutic use
  • Cephalosporins / therapeutic use
  • Humans
  • Microbial Sensitivity Tests
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma*
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas aeruginosa / metabolism
  • Salvage Therapy
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism

Substances

  • beta-lactamase NDM-1
  • Cephalosporins
  • Anti-Bacterial Agents
  • beta-Lactamases
  • Azabicyclo Compounds