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January 14, 2026Open Forum Infectious DiseasesOpen Access

P-1197. NDM-5 and Siderophore Receptor Mutations Drive High Level Cefiderocol Resistance in Klebsiella pneumoniae: A Case Series

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Authors

MPMichelle PotterWAWajih AskarGGGerardo F Gomez-Abundis

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Overview

Case series shows cefiderocol resistance in klebsiella pneumoniae infections, indicating challenges for treatment strategies.

Key Points

  • To investigate high-level cefiderocol resistance in NDM-producing Klebsiella pneumoniae infections.
  • Case series involving 12 patients with cefiderocol-resistant NDM-producing K. pneumoniae infections from January 2023 to July 2024.
  • Whole genome sequencing was performed to analyze resistance mechanisms and mutations in siderophore transporters and porins.
  • Outcomes included monitoring for microbiologic recurrence and treatment efficacy.
  • Cefiderocol resistance was observed despite some patients lacking prior exposure.
  • NDM-5 was identified in all analyzed isolates, along with additional mutations linked to resistance.
  • Treatment with ceftazidime/avibactam plus aztreonam was effective for most, although recurrence occurred.

Cite This Study

Potter et al. (2026) studied this question.

synapsesocial.com/papers/6966f30613bf7a6f02c00849https://doi.org/10.1093/ofid/ofaf695.1390
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cefiderocol Heteroresistance in NDM-Producing Enterobacterales: A Complex Polymicrobial Infection Successfully Salvaged With Ceftazidime-Avibactam Plus Aztreonam2026 · 1 citations
  2. 2Evaluation of the in vitro susceptibility of clinical isolates of NDM-producing Klebsiella pneumoniae to new antibiotics included in a treatment regimen for infections2024 · 9 citations
  3. 3P-1067. Navigating the Dual Threat: Clinical Outcomes in Patients with KPC and NDM Co-producing Enterobacterales Infections2026
  4. 4INFECTIONS CAUSED BY NDM- AND NDM+KPC-PRODUCING ENTEROBACTERALES: EPIDEMIOLOGICAL PROFILE IN A UNIVERSITY HOSPITAL2026
  5. 5630. Protective Role of Outer Membrane Vesicles Released by Carbapenemase-Producing Klebsiella pneumoniae Clinical Isolates Against Carbapenems and Cefiderocol2026