Case report illustrates improved outcomes with optimized therapy for multidrug-resistant Escherichia coli infections, suggesting better treatment strategies.
A 65-year-old man without identifiable risk factors for multidrug-resistant pathogens was admitted with peritonitis, isolating NDM-producing Escherichia coli from a rectal swab and intraoperative samples. After surgery, ceftazidime-avibactam/aztreonam was administered. Due to poor clinical response, he was switched to imipenem-relebactam/aztreonam, resulting in a successful outcome. Whole-genome sequencing detected bla NDM-5 and bla CMY-148 β-lactamases, PBP3 YRIN insertion, and mutated cirA gene. This case illustrates the importance of considering different mechanisms of resistance when choosing combination therapy.
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Fabrizio et al. (2026) studied this question.
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