We report 2 independent patients from whom carbapenem and ceftazidime-avibactam–resistant Enterobacter cloacae complex strains were identified. The ceftazidime-avibactam resistance was attributed to a 2–amino acid deletion in the R2 loop of AmpC β-lactamase, which concurrently caused resistance to cefepime and reduced susceptibility to cefiderocol, a novel siderophore cephalosporin.

中文翻译：

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暴露于头孢吡肟的阴沟肠杆菌复合物中AmpC介导的头孢他啶-阿维巴坦和头孢地洛尔耐药的临床演变

我们报告了2名独立患者，他们从中鉴定出了碳青霉烯和头孢他啶-阿维巴坦耐药的阴沟肠杆菌复杂菌株。头孢他啶-avibactam耐药性归因于AmpCβ-内酰胺酶R2环中的2个氨基酸缺失，同时引起对头孢吡肟的耐药性并降低了对头孢吡罗（一种新型铁载体头孢菌素）的敏感性。