{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:14:42Z","timestamp":1793060082600,"version":"4.5.0"},"reference-count":23,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              The\n              <jats:italic>in vitro<\/jats:italic>\n              activity of two novel antibiotics with different modes of action, (i) siderophore cefiderocol and (ii) \u03b2-lactam-enhancer mechanism-based cefepime\/zidebactam, was tested against New Delhi Metallo-\u03b2-lactamase (NDM)-producing Enterobacterales and\n              <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n              collected in India. Minimum inhibitory concentrations of antibiotics against multicentric NDM-producing\n              <jats:italic>Escherichia coli<\/jats:italic>\n              (\n              <jats:italic>n<\/jats:italic>\n              = 117),\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              (\n              <jats:italic>n<\/jats:italic>\n              = 103), and\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              (\n              <jats:italic>n<\/jats:italic>\n              = 72) were determined by the reference broth microdilution method. Among\n              <jats:italic>E. coli<\/jats:italic>\n              , 111 isolates were NDM-alone, and six were NDM + OXA-48-like producers. Among\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              , 47 and 56 isolates were NDM-alone and NDM + OXA-48-like producers, respectively. All\n              <jats:italic>E. coli<\/jats:italic>\n              isolates harbored four amino acid inserts in their penicillin-binding protein 3. Using the highest susceptible breakpoint among CLSI, FDA, and EUCAST interpretive criteria, cefiderocol susceptibility was 39.3%, \u226480%, and 57%, for NDM \u00b1 OXA-48-like-producing\n              <jats:italic>E. coli<\/jats:italic>\n              , NDM \u00b1 OXA-48-like-producing\n              <jats:italic>K. pneumoniae,<\/jats:italic>\n              and NDM-producing\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              , respectively. At a cefepime break point of \u22648 mg\/L, 100% of Enterobacterales and \u226590% of\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              isolates were cefepime\/zidebactam-susceptible. NDM being a dominant carbapenemase among Enterobacterales and\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              in India, the variable activity of cefiderocol against NDM producers is a concern. Post approval, cefepime\/zidebactam could offer a promising treatment option against NDM producers.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              Metallo-\u03b2-lactamases are therapeutically challenging due to the limited treatment options. Against such isolates, currently approved newer \u03b2-lactam\/\u03b2-lactamase inhibitor combinations are ineffective. In this study, we tested siderophore cephalosporin, cefiderocol, which utilizes an unconventional iron uptake pathway for efficient cellular penetration, and cefepime\/zidebactam that utilizes novel \u03b2-lactam enhancer mechanisms for overcoming diverse carbapenemases. Cefiderocol showed limited activity against\n              <jats:italic>Escherichia coli<\/jats:italic>\n              isolates co-harboring New Delhi metallo-\u03b2-lactamase (NDM) with PBP3 insert, dual carbapenemase (NDM with OXA-48 like)-producing\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              , and NDM-producing\n              <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n              isolates, while cefepime\/zidebactam potently inhibited NDM-producing Enterobacterales and\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              isolates. NDM being a dominant carbapenemase among Enterobacterales and\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              in India, the variable activity of cefiderocol against NDM producers is a concern. Post approval, cefepime\/zidebactam could offer a promising treatment option against NDM producers.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.00497-24","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T14:00:24Z","timestamp":1732024824000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":15,"title":["Tackling the unyielding: testing two novel approaches against NDM-producing Enterobacterales and\n            <i>Pseudomonas aeruginosa<\/i>\n            isolates collected in India"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8840-3255","authenticated-orcid":false,"given":"Yamuna Devi","family":"Bakthavatchalam","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology, Christian Medical College","place":["Vellore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijayini","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences","place":["Bhubaneswar, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Zydus Hospitals","place":["Ahmedabad, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4429-3688","authenticated-orcid":true,"given":"Purva","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Post Graduate Medical Education and Research","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir Ahmed","family":"Fomda","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences","place":["Srinagar, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamini","family":"Walia","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8662-4257","authenticated-orcid":false,"given":"Balaji","family":"Veeraraghavan","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Christian Medical College","place":["Vellore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00397-20"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30868-9"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2016.1222343"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2249-x"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa021"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02670-21"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2022.115652"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.04925-22"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02171-20"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa036"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00128-19"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2010.12.002"},{"key":"e_1_3_3_14_2","volume-title":"CLSI supplement M100","author":"Institute CaLS","year":"2022","unstructured":"Institute CaLS. 2022. Performance Standards for Antimicrobial Susceptibility Testing. 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