Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan

Objective: Cefiderocol, a siderophore cephalosporin, has shown promise against carbapenem-resistant strains such as Pseudomonas aeruginosa and Stenotrophomonas maltophilia species complex. Despite its recent approval in Japan, susceptibility data remain limited. Therefore, this study evaluated the c...

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Main Authors: Wataru Aoki, Yoshifumi Uwamino, Nagi Niida, Hiroaki Kubota, Yuka Kamoshita, Rika Inose, Mika Nagata, Osamu Ishihara, Shunsuke Uno, Ayumi Yoshifuji, Ho Namkoong, Naoki Hasegawa, Hiromichi Matsushita
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716525001584
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author Wataru Aoki
Yoshifumi Uwamino
Nagi Niida
Hiroaki Kubota
Yuka Kamoshita
Rika Inose
Mika Nagata
Osamu Ishihara
Shunsuke Uno
Ayumi Yoshifuji
Ho Namkoong
Naoki Hasegawa
Hiromichi Matsushita
author_facet Wataru Aoki
Yoshifumi Uwamino
Nagi Niida
Hiroaki Kubota
Yuka Kamoshita
Rika Inose
Mika Nagata
Osamu Ishihara
Shunsuke Uno
Ayumi Yoshifuji
Ho Namkoong
Naoki Hasegawa
Hiromichi Matsushita
author_sort Wataru Aoki
collection DOAJ
description Objective: Cefiderocol, a siderophore cephalosporin, has shown promise against carbapenem-resistant strains such as Pseudomonas aeruginosa and Stenotrophomonas maltophilia species complex. Despite its recent approval in Japan, susceptibility data remain limited. Therefore, this study evaluated the cefiderocol susceptibility of carbapenem-resistant P. aeruginosa and S. maltophilia species complex strains isolated from blood cultures to determine whether cefiderocol can be used as an empirical treatment option. Methods: Carbapenem-resistant P. aeruginosa and S. maltophilia species complex strains isolated from blood cultures at a university hospital in Japan were included. Minimum inhibitory concentrations (MICs) and inhibition zone diameters were assessed using broth microdilution and disk diffusion methods, respectively. Whole-genome sequencing was conducted to elucidate the genetic backgrounds of the clinical isolates. Results: The MIC50 and MIC90 values for cefiderocol in 65 carbapenem-resistant P. aeruginosa strains were 0.12 and 0.25 µg/mL, and 0.06 and 0.25 µg/mL for 51 S. maltophilia species complex strains, respectively. One S. maltophilia species complex strain exhibited non-susceptibility, with a MIC of 2 µg/mL in broth microdilution, while disk diffusion methods demonstrated susceptibility. A significant negative correlation was observed between MIC values and inhibition zone diameters. Whole-genome sequencing revealed that a limited number of P. aeruginosa strains possessed carbapenemase genes. Conclusions: The findings of this study support the efficacy of cefiderocol against carbapenem-resistant P. aeruginosa and S. maltophilia species complex, suggesting its potential as an empirical treatment option for bloodstream infection patients in Japan. Continued surveillance is advised to monitor resistance trends with increased cefiderocol use.
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spelling doaj-art-d018bf7626674133a69a70c1c55bbfd62025-08-20T03:56:42ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-09-014425125510.1016/j.jgar.2025.07.004Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, JapanWataru Aoki0Yoshifumi Uwamino1Nagi Niida2Hiroaki Kubota3Yuka Kamoshita4Rika Inose5Mika Nagata6Osamu Ishihara7Shunsuke Uno8Ayumi Yoshifuji9Ho Namkoong10Naoki Hasegawa11Hiromichi Matsushita12Clinical Laboratory, Keio University Hospital, Tokyo, JapanDepartment of Laboratory Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan; Corresponding author. Mailing address: Department of Laboratory Medicine, Keio University School of Medicine. 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.Clinical Laboratory, Keio University Hospital, Tokyo, JapanDepartment of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, JapanDepartment of Laboratory Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, JapanClinical Laboratory, Keio University Hospital, Tokyo, JapanClinical Laboratory, Keio University Hospital, Tokyo, JapanClinical Laboratory, Keio University Hospital, Tokyo, JapanDepartment of Infectious Diseases, Keio University School of Medicine, Tokyo, JapanDepartment of Infectious Diseases, Keio University School of Medicine, Tokyo, JapanDepartment of Infectious Diseases, Keio University School of Medicine, Tokyo, JapanDepartment of Infectious Diseases, Keio University School of Medicine, Tokyo, JapanDepartment of Laboratory Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, JapanObjective: Cefiderocol, a siderophore cephalosporin, has shown promise against carbapenem-resistant strains such as Pseudomonas aeruginosa and Stenotrophomonas maltophilia species complex. Despite its recent approval in Japan, susceptibility data remain limited. Therefore, this study evaluated the cefiderocol susceptibility of carbapenem-resistant P. aeruginosa and S. maltophilia species complex strains isolated from blood cultures to determine whether cefiderocol can be used as an empirical treatment option. Methods: Carbapenem-resistant P. aeruginosa and S. maltophilia species complex strains isolated from blood cultures at a university hospital in Japan were included. Minimum inhibitory concentrations (MICs) and inhibition zone diameters were assessed using broth microdilution and disk diffusion methods, respectively. Whole-genome sequencing was conducted to elucidate the genetic backgrounds of the clinical isolates. Results: The MIC50 and MIC90 values for cefiderocol in 65 carbapenem-resistant P. aeruginosa strains were 0.12 and 0.25 µg/mL, and 0.06 and 0.25 µg/mL for 51 S. maltophilia species complex strains, respectively. One S. maltophilia species complex strain exhibited non-susceptibility, with a MIC of 2 µg/mL in broth microdilution, while disk diffusion methods demonstrated susceptibility. A significant negative correlation was observed between MIC values and inhibition zone diameters. Whole-genome sequencing revealed that a limited number of P. aeruginosa strains possessed carbapenemase genes. Conclusions: The findings of this study support the efficacy of cefiderocol against carbapenem-resistant P. aeruginosa and S. maltophilia species complex, suggesting its potential as an empirical treatment option for bloodstream infection patients in Japan. Continued surveillance is advised to monitor resistance trends with increased cefiderocol use.http://www.sciencedirect.com/science/article/pii/S2213716525001584CefiderocolCarbapenem resistanceStenotrophomonas maltophiliaPseudomonas aeruginosaBloodstream infectionSusceptibility
spellingShingle Wataru Aoki
Yoshifumi Uwamino
Nagi Niida
Hiroaki Kubota
Yuka Kamoshita
Rika Inose
Mika Nagata
Osamu Ishihara
Shunsuke Uno
Ayumi Yoshifuji
Ho Namkoong
Naoki Hasegawa
Hiromichi Matsushita
Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan
Journal of Global Antimicrobial Resistance
Cefiderocol
Carbapenem resistance
Stenotrophomonas maltophilia
Pseudomonas aeruginosa
Bloodstream infection
Susceptibility
title Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan
title_full Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan
title_fullStr Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan
title_full_unstemmed Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan
title_short Cefiderocol susceptibility of Stenotrophomonas maltophilia species complex and carbapenem-resistant Pseudomonas aeruginosa isolates from blood cultures at a university hospital in Tokyo, Japan
title_sort cefiderocol susceptibility of stenotrophomonas maltophilia species complex and carbapenem resistant pseudomonas aeruginosa isolates from blood cultures at a university hospital in tokyo japan
topic Cefiderocol
Carbapenem resistance
Stenotrophomonas maltophilia
Pseudomonas aeruginosa
Bloodstream infection
Susceptibility
url http://www.sciencedirect.com/science/article/pii/S2213716525001584
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