An NDM-Producing Escherichia coli Clinical Isolate Exhibiting Resistance to Cefiderocol and the Combination of Ceftazidime-Avibactam and Aztreonam: Another Step Towards Pan-β-Lactam Resistance

  19 May 2023

Cefiderocol and ceftazidime-avibactam plus aztreonam (CZA-ATM) are preferred treatment regimens for NDM-producing infections.

We report the case of a United States patient who traveled to India to receive a renal transplant. He subsequently experienced pyelonephritis by an NDM-producing Escherichia coli. Broth microdilution and the broth disk elution method indicated resistance to all β-lactams, including cefiderocol and CZA-ATM. WGS investigations were undertaken to identify resistance mechanisms.

This is the first clinical case of a United States patient harboring an NDM-producing isolate exhibiting resistance to all available β-lactam agents. 


Author(s): Patricia J Simner, Yehudit Bergman, Rick Conzemius, Emily Jacobs, Tsigereda Tekle, Stephan Beisken, Pranita D Tamma
Effective Surveillance  


Unrestricted financial support by:

Antimicrobial Resistance Fighter Coalition

Bangalore Bioinnovation Centre


JSS University


Global Ambassador Network

Welcome at the AMR Insights Ambassador Network!

The AMR Insights Ambassador Network is a growing, distinctive group of professionals who stand out for their commitment, willingness to cooperate and open attitude to combat Antimicrobial resistance (AMR).

More information and free-of-charge registration
What is going on with AMR?
Stay tuned with remarkable global AMR news and developments!