Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance

<i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) has emerged as a prominent multidrug-resistant (MDR) pathogen, significantly complicating treatment strategies due to its formidable resistance mechanisms, particularly against carbapenems. Reduced membrane permeability, ac...

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Main Authors: Bahman Yousefi, Setayesh Kashanipoor, Payman Mazaheri, Farnaz Alibabaei, Ali Babaeizad, Shima Asli, Sina Mohammadi, Amir Hosein Gorgin, Tahereh Alipour, Valentyn Oksenych, Majid Eslami
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/12/11/2532
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author Bahman Yousefi
Setayesh Kashanipoor
Payman Mazaheri
Farnaz Alibabaei
Ali Babaeizad
Shima Asli
Sina Mohammadi
Amir Hosein Gorgin
Tahereh Alipour
Valentyn Oksenych
Majid Eslami
author_facet Bahman Yousefi
Setayesh Kashanipoor
Payman Mazaheri
Farnaz Alibabaei
Ali Babaeizad
Shima Asli
Sina Mohammadi
Amir Hosein Gorgin
Tahereh Alipour
Valentyn Oksenych
Majid Eslami
author_sort Bahman Yousefi
collection DOAJ
description <i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) has emerged as a prominent multidrug-resistant (MDR) pathogen, significantly complicating treatment strategies due to its formidable resistance mechanisms, particularly against carbapenems. Reduced membrane permeability, active antibiotic efflux, and enzymatic hydrolysis via different β-lactamases are the main resistance mechanisms displayed by <i>A. baumannii</i>, and they are all effective against successful treatment approaches. This means that alternate treatment approaches, such as combination therapy that incorporates beta-lactams, β-lactamase inhibitors, and novel antibiotics like cefiderocol, must be investigated immediately. Cefiderocol, a new catechol-substituted siderophore cephalosporin, improves antibacterial activity by allowing for better bacterial membrane penetration. Due to its unique structure, cefiderocol can more efficiently target and destroy resistant bacteria by using iron transport systems. Through its inhibition of peptidoglycan formation through binding to penicillin-binding proteins (PBPs), cefiderocol avoids conventional resistance pathways and induces bacterial cell lysis. The possibility of resistance development due to β-lactamase synthesis and mutations in PBPs, however, emphasizes the need for continued investigation into cefiderocol’s efficacy in combination treatment regimes. Cefiderocol’s siderophore mimic mechanism is especially important in iron-limited conditions because it can use ferric-siderophore transporters to enter cells. Additionally, its passive diffusion through bacterial porins increases its intracellular concentrations, making it a good option for treating carbapenem-resistant <i>A. baumannii</i>, especially in cases of severe infections and ventilator-associated diseases (IVACs). Cefiderocol may reduce MDR infection morbidity and mortality when combined with customized antimicrobial treatments, but further investigation is needed to improve patient outcomes and address <i>A. baumannii</i> resistance issues.
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spelling doaj-art-7d0397c52cd9477a96be189168d764a42025-08-20T01:53:44ZengMDPI AGBiomedicines2227-90592024-11-011211253210.3390/biomedicines12112532Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and ResistanceBahman Yousefi0Setayesh Kashanipoor1Payman Mazaheri2Farnaz Alibabaei3Ali Babaeizad4Shima Asli5Sina Mohammadi6Amir Hosein Gorgin7Tahereh Alipour8Valentyn Oksenych9Majid Eslami10Cancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranCancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranCancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranCancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranCancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranCancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranStudent Research Committee, School of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranStudent Research Committee, School of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, IranNervous System Stem Cell Research Center, Semnan University of Medical Sciences, Semnan 35147-99442, IranDepartment of Clinical Science, University of Bergen, 5020 Bergen, NorwayDepartment of bacteriology and Virology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan 35147-99442, Iran<i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) has emerged as a prominent multidrug-resistant (MDR) pathogen, significantly complicating treatment strategies due to its formidable resistance mechanisms, particularly against carbapenems. Reduced membrane permeability, active antibiotic efflux, and enzymatic hydrolysis via different β-lactamases are the main resistance mechanisms displayed by <i>A. baumannii</i>, and they are all effective against successful treatment approaches. This means that alternate treatment approaches, such as combination therapy that incorporates beta-lactams, β-lactamase inhibitors, and novel antibiotics like cefiderocol, must be investigated immediately. Cefiderocol, a new catechol-substituted siderophore cephalosporin, improves antibacterial activity by allowing for better bacterial membrane penetration. Due to its unique structure, cefiderocol can more efficiently target and destroy resistant bacteria by using iron transport systems. Through its inhibition of peptidoglycan formation through binding to penicillin-binding proteins (PBPs), cefiderocol avoids conventional resistance pathways and induces bacterial cell lysis. The possibility of resistance development due to β-lactamase synthesis and mutations in PBPs, however, emphasizes the need for continued investigation into cefiderocol’s efficacy in combination treatment regimes. Cefiderocol’s siderophore mimic mechanism is especially important in iron-limited conditions because it can use ferric-siderophore transporters to enter cells. Additionally, its passive diffusion through bacterial porins increases its intracellular concentrations, making it a good option for treating carbapenem-resistant <i>A. baumannii</i>, especially in cases of severe infections and ventilator-associated diseases (IVACs). Cefiderocol may reduce MDR infection morbidity and mortality when combined with customized antimicrobial treatments, but further investigation is needed to improve patient outcomes and address <i>A. baumannii</i> resistance issues.https://www.mdpi.com/2227-9059/12/11/2532<i>Acinetobacter baumannii</i>β-lactamasecarbapenemcefiderocolPBP
spellingShingle Bahman Yousefi
Setayesh Kashanipoor
Payman Mazaheri
Farnaz Alibabaei
Ali Babaeizad
Shima Asli
Sina Mohammadi
Amir Hosein Gorgin
Tahereh Alipour
Valentyn Oksenych
Majid Eslami
Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance
Biomedicines
<i>Acinetobacter baumannii</i>
β-lactamase
carbapenem
cefiderocol
PBP
title Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance
title_full Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance
title_fullStr Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance
title_full_unstemmed Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance
title_short Cefiderocol in Combating Carbapenem-Resistant <i>Acinetobacter baumannii</i>: Action and Resistance
title_sort cefiderocol in combating carbapenem resistant i acinetobacter baumannii i action and resistance
topic <i>Acinetobacter baumannii</i>
β-lactamase
carbapenem
cefiderocol
PBP
url https://www.mdpi.com/2227-9059/12/11/2532
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