In Vivo Emergence of Cefiderocol and Ceftazidime/avibactam Cross-Resistance in KPC-producing Klebsiella Pneumoniae Following Ceftazidime/avibactam -Based Therapies

We described the emergence of ceftazidime/avibactam and cefiderocol cross-resistance in patients with KPC-producing Klebsiella pneumoniae infections. All strains with ceftazidime/avibactam and cefiderocol cross-resistance showed point mutations on KPC Ω-loop. Taken together, our results indicate that prolonged exposure to ceftazidime/avibactam can confer cross-resistance to ceftazidime/avibactam and cefiderocol.