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Lasarte-Monterrubio C, Guijarro-Sánchez P, Vázquez-Ucha JC, Alonso-Garcia I, Alvarez-Fraga L, Outeda M, Martinez-Guitian M, Peña-Escolano A, Maceiras R, Lence E, González-Bello C, Arca-Suárez J, Bou G, Beceiro A. Antimicrobial Activity of Cefiderocol against the Carbapenemase-Producing Enterobacter cloacae Complex and Characterization of Reduced Susceptibility Associated with Metallo-β-Lactamase VIM-1. Antimicrob Agents Chemother 2023; 67:e0150522. [PMID: 37195077 PMCID: PMC10190674 DOI: 10.1128/aac.01505-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/16/2023] [Indexed: 05/18/2023] Open
Abstract
Emergence of cefiderocol resistance among carbapenemase-producing Enterobacterales, particularly those in the Enterobacter cloacae complex (ECC), is becoming of alarming concern; however, the mechanistic basis of this phenomenon remains poorly understood. We describe the acquisition of VIM-1-mediated reduced cefiderocol susceptibility (MICs 0.5 to 4 mg/L) in a collection of 54 carbapenemase-producing isolates belonging to the ECC. MICs were determined by reference methodologies. Antimicrobial resistance genomic analysis was performed through hybrid WGS. The impact of VIM-1 production on cefiderocol resistance in the ECC background was examined at microbiological, molecular, biochemical, and atomic levels. Antimicrobial susceptibility testing yielded 83.3% susceptible isolates and MIC50/90 values of 1/4 mg/L. Decreased susceptibility to cefiderocol was mainly associated with isolates producing VIM-1, with cefiderocol MICs 2- to 4-fold higher than for isolates carrying other types of carbapenemases. E. cloacae and Escherichia coli VIM-1 transformants displayed significantly enhanced cefiderocol MICs. Biochemical assays with purified VIM-1 protein revealed low but detectable cefiderocol hydrolysis. Simulation studies revealed how cefiderocol is anchored to the VIM-1 active site. Additional molecular assays and WGS data analysis highlighted the implication of SHV-12 coproduction and suggested the inactivation of the FcuA-like siderophore receptor as further contributors to the higher cefiderocol MICs. Our findings warn of the potential of the VIM-1 carbapenemase to at least partly limit the activity of cefiderocol in the ECC. This effect is probably enhanced due to combination with additional mechanisms, such as ESBL production and siderophore inactivation, and indicates the need for active surveillance to extend the life span of this promising cephalosporin.
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Affiliation(s)
- Cristina Lasarte-Monterrubio
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Paula Guijarro-Sánchez
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Juan Carlos Vázquez-Ucha
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Isaac Alonso-Garcia
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Laura Alvarez-Fraga
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Michelle Outeda
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Marta Martinez-Guitian
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
- NANOBIOFAR, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Andrea Peña-Escolano
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Romina Maceiras
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Emilio Lence
- Centre for Research in Biological Chemistry and Molecular Materials (CiQUS), Department of Organic Chemistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Concepción González-Bello
- Centre for Research in Biological Chemistry and Molecular Materials (CiQUS), Department of Organic Chemistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Jorge Arca-Suárez
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - German Bou
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
| | - Alejandro Beceiro
- Microbiology Department, A Coruña University Hospital Complex (CHUAC), A Coruña Institute for Biomedical Research (INIBIC), CIBER de Enfermedades Infecciosas (CIBERINFEC), A Coruña, Spain
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González-Bello C, Tizón L, Lence E, Otero JM, van Raaij MJ, Martinez-Guitian M, Beceiro A, Thompson P, Hawkins AR. Chemical Modification of a Dehydratase Enzyme Involved in Bacterial Virulence by an Ammonium Derivative: Evidence of its Active Site Covalent Adduct. J Am Chem Soc 2015; 137:9333-43. [DOI: 10.1021/jacs.5b04080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | - Mark J. van Raaij
- Departamento
de Estructura de Macromoléculas, Centro Nacional de Biotecnología (CSIC), Campus Cantoblanco, 28049 Madrid, Spain
| | - Marta Martinez-Guitian
- Servicio
de Microbiología-INIBIC, Complejo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Alejandro Beceiro
- Servicio
de Microbiología-INIBIC, Complejo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Paul Thompson
- Institute
of Cell and Molecular Biosciences, Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Alastair R. Hawkins
- Institute
of Cell and Molecular Biosciences, Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, United Kingdom
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