{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:36:22Z","timestamp":1791905782598,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    is a major Gram-negative pathogen causing diverse infections, including complicated urinary tract infections (cUTIs). Although such cUTIs are usually treatable with standard antipseudomonal \u03b2-lactams, the rise of carbapenem-resistant\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    , particularly those producing New Delhi metallo-\u03b2-lactamase (NDM), has made therapeutic options extremely limited. We report a 58-year-old man with diabetes, hypertension, and ischemic heart disease who presented with pyelonephritis in the setting of a long-retained ureteric stent. Urine culture grew\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    resistant to meropenem, and molecular testing confirmed the presence of NDM. The whole-genome sequencing revealed that the isolate belonged to high-risk sequence type 308 clone carrying NDM-1 and multiple additional resistance determinants. Given the lack of effective alternative antibiotics and the patient\u2019s deteriorating clinical course with underlying renal impairment precluding the use of colistin, investigational drug cefepime\/zidebactam (WCK 5222) was initiated under compassionate ground. The patient underwent source control with percutaneous nephrostomy and stone clearance. He received 37 days of cefepime\/zidebactam, during which he showed rapid clinical improvement, resolution of pyelonephritis, and sterile urine cultures. This case underscores how infections such as cUTI or pyelonephritis, usually considered manageable, can become untreatable in NDM-endemic settings and highlights cefepime\/zidebactam as a promising therapeutic option for highly resistant\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.1177\/10766294261430068","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:51:41Z","timestamp":1775044301000},"page":"177-181","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Pyelonephritis Caused by\n                    <i>Pseudomonas aeruginosa<\/i>\n                    : From Treatable Infection to Therapeutic Dead-End, Rescued by an Investigational Antibiotic"],"prefix":"10.1177","volume":"32","author":[{"given":"Bhavik","family":"Thacker","sequence":"first","affiliation":[{"name":"Fellow, Infectious Diseases, Marengo CIMS, Ahmedabad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surabhi","family":"Madan","sequence":"additional","affiliation":[{"name":"Infectious Diseases Consultant, Marengo CIMS, Ahmedabad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhara","family":"Pethani","sequence":"additional","affiliation":[{"name":"Registrar, Infectious Diseases, Marengo CIMS, Ahmedabad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parth","family":"Nathwani","sequence":"additional","affiliation":[{"name":"Consultant Urology, Marengo CIMS, Ahmedabad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavini","family":"Shah","sequence":"additional","affiliation":[{"name":"Consultant Microbiology, Marengo CIMS, Ahmedabad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirtan","family":"Shah","sequence":"additional","affiliation":[{"name":"Consultant Radiology, Marengo CIMS, Ahmedabad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji","family":"Veeraraghavan","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Christian Medical College, Vellore, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.29074\/ascls.24.1.43"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1286-4579(00)01259-4"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2013\/5509.3137"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00497-24"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/molecules26092671"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae403"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab026"},{"key":"e_1_3_5_9_2","unstructured":"Clinical and Laboratory Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 35th ed. Volume 45 Number 1. CLSI Supplement M100. Clinical and laboratory Institute; USA 2024. Available from: https:\/\/em100.edaptivedocs.net\/partner\/clsi\/m100\/CLSIInvestigationalUseOnlyBreakpoints2024.pdf"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.04033-22"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanmic.2024.100958"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01635-6"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2025.08.018"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmech.2023.115778"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics16020185"},{"key":"e_1_3_5_16_2","volume-title":"34th European Congress of Clinical Microbiology and Infectious Diseases","author":"Lodise T","year":"2024","unstructured":"Lodise T, , Muller AE, , Bakthavatchalam Y, et al. In vitro activity of cefepime\/zidebactam (WCK 5222) against a panel of MDR\/XDR Pseudomonas Aeruginosa (PSA) isolates from India enriched with resistance to novel \u03b2-lactam\/\u03b2-lactamase inhibitor (BL\/BLI) combinations. In: 34th European Congress of Clinical Microbiology and Infectious Diseases. ECCMID: Barcelona, Spain; 2024."},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00233-19"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz414"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.01118-23"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00500-23"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-023-00606-x"},{"key":"e_1_3_5_22_2","volume-title":"ID week; 2016 October 26\u201330","author":"Bhatia A","year":"2016","unstructured":"Bhatia A, , Gupta M, , Chugh R, et al. Zidebactam Phase I single ascending dose and crossover study in healthy subjects [P-2236]. In: ID week; 2016 October 26\u201330, Infectious Diseases Society of America: New Orleans, LA, USA. San Diego; 2016."},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2020.106196"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294261430068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10766294261430068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294261430068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:20:44Z","timestamp":1777684844000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10766294261430068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,1]]}},"alternative-id":["10.1177\/10766294261430068"],"URL":"https:\/\/doi.org\/10.1177\/10766294261430068","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}