Cefiderocol is a siderophore cephalosporin with potent antibacterial activity against a broad range of Gram-negative pathogens, including multidrug-resistant strains. Siderophore antibiotics bind ferric iron and utilize iron transporters to cross the cell membrane. In the biofilm setting, where antibiotic resistance is high but iron scavenging is important, cefiderocol may have advantageous antimicrobial properties. In this study, we compared the antimicrobial activity of cefiderocol to that of seven commonly used antibiotics in well-characterized multidrug-resistant pathogens and then determined their efficacy in the biofilm setting. MIC₉₀ values for cefiderocol were consistently lower than those of other antibiotics (ceftolozane-tazobactam, ceftazidime-avibactam, ceftazidime, piperacillin-tazobactam, imipenem, and tobramycin) in all strains tested. Cefiderocol treatment displayed a reduction in the levels of Pseudomonas aeruginosa biofilm (93%, P < 0.0001) superior to that seen with the other antibiotics (49% to 82%). Cefiderocol was generally as effective as or superior to the other antibiotics, depending on the pathogen-antibiotic combination, in reducing biofilm in other pathogens. There was a trend toward greater biofilm reduction seen with increased antibiotic dose or with increased frequency of antibiotic treatment. We conclude that cefiderocol effectively reduces biofilm and is a potent inhibitor of planktonic growth across a range of Gram-negative medically important pathogens.

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头孢地洛尔在多药耐药革兰氏阴性病原体中保留抗生物膜活性

头孢地洛尔是一种铁载体头孢菌素，具有对多种革兰氏阴性病原体（包括耐多药菌株）的有效抗菌活性。铁载体抗生素结合三价铁，并利用铁转运蛋白穿过细胞膜。在生物膜环境中，对抗生素的抵抗力很高，但对铁的清除很重要，头孢地洛尔可能具有有利的抗菌性能。在这项研究中，我们将头孢地洛尔与七种常用抗生素在特征明确的耐多药病原体中的抗菌活性进行了比较，然后确定了它们在生物膜环境中的功效。麦克风₉₀在所有测试的菌株中，头孢地洛尔的值始终低于其他抗生素（头孢噻嗪-他唑巴坦，头孢他啶-avibactam，头孢他啶，哌拉西林-他唑巴坦，亚胺培南和妥布霉素）。头孢地洛尔治疗显示铜绿假单胞菌生物膜水平降低（93％，P<0.0001）优于其他抗生素（<49％至82％）。根据病原体-抗生素的组合，头孢地洛尔在减少其他病原体的生物膜方面通常与其他抗生素一样有效或优于其他抗生素。随着抗生素剂量的增加或抗生素治疗频率的增加，生物膜减少的趋势有所增加。我们得出的结论是，头孢地洛可有效减少生物膜，并且在多种革兰氏阴性医学重要病原体中是浮游生物生长的有效抑制剂。