Detection of cefiderocol and aztreonam/avibactam resistance in epidemic Escherichia coli ST-361 carrying blaNDM-5 and blaKPC-3 from foreign fighters evacuated from Ukraine

Antimicrob Agents Chemother. 2024 Nov 6;68(11):e0109024. doi: 10.1128/aac.01090-24. Epub 2024 Sep 20.

Abstract

Genomic surveillance detected clonal Escherichia coli sequence type-361 isolates carrying blaNDM-5, blaKPC-3, blaCTX-M-15, and rmtB1 from a patient in Ukraine and four wounded foreign soldiers evacuated to Germany. Isolates were non-susceptible to carbapenems, aminoglycosides, and cefiderocol and aztreonam/avibactam due to a PBP3 YRIN insertion and the blaCMY-145 AmpC β-lactamase. Coordinated surveillance efforts across civilian, military, and veteran healthcare systems are essential to prevent further spread as international volunteers return home after medical evacuation from Ukraine.

Keywords: Ukraine; antibiotic resistance; carbapenem resistance; genomic surveillance.

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Azabicyclo Compounds* / pharmacology
  • Aztreonam* / pharmacology
  • Bacterial Proteins / genetics
  • Cefiderocol*
  • Cephalosporins* / pharmacology
  • Cyclooctanes / pharmacology
  • Drug Resistance, Multiple, Bacterial / genetics
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / microbiology
  • Escherichia coli Proteins / genetics
  • Escherichia coli* / drug effects
  • Escherichia coli* / genetics
  • Germany
  • Humans
  • Microbial Sensitivity Tests*
  • Military Personnel
  • Ukraine / epidemiology
  • beta-Lactamases* / genetics

Substances

  • beta-Lactamases
  • Aztreonam
  • Azabicyclo Compounds
  • Anti-Bacterial Agents
  • Cephalosporins
  • Cefiderocol
  • Escherichia coli Proteins
  • beta lactamase NDM-5, E coli
  • Bacterial Proteins
  • avibactam
  • Cyclooctanes
  • AmpC beta-lactamases