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March 21, 2026American Journal of Case ReportsOpen Access

Cefiderocol Heteroresistance in NDM-Producing Enterobacterales: A Complex Polymicrobial Infection Successfully Salvaged With Ceftazidime-Avibactam Plus Aztreonam

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Authors

MNMustafa NuaimiJCJonathan CirilloSUSara Usbosy

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Overview

Case report reveals cefiderocol heteroresistance in NDM-producing Enterobacterales, indicating the need for advanced antimicrobial evaluation.

Key Points

  • To investigate the clinical implications of cefiderocol heteroresistance in NDM-producing Enterobacterales during polymicrobial infections.
  • Case report of a 64-year-old woman with a persistent polymicrobial infection.
  • Evaluation of discords in susceptibility from different anatomical sites.
  • Advanced microbiological assessments to determine efficacy of combination therapy.
  • Cefiderocol resistance was observed in respiratory isolates while wound isolates remained susceptible.
  • Therapeutic transition to ceftazidime-avibactam plus aztreonam resulted in clinical stabilization.
  • Left above-knee amputation was necessary due to progressive necrotizing infection.

Cite This Study

Nuaimi et al. (2026) studied this question.

synapsesocial.com/papers/69be371c6e48c4981c6767f2https://doi.org/10.12659/ajcr.952266
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