JAC-antimicrobial resistance · 2026
Effective cefiderocol CSF penetration for treating Stenotrophomonas maltophilia ventriculitis.
СтатьяНазвание и аннотация: Перевод в очереди
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Ribera Clara, Padullés Ariadna, Tubau Fe, Corral Luisa, Nuñez Garate Maria, Cabellos Carmen, Vilalta Alexandre, Càmara Jordi, Cobo-Sacristán Sara, Abelenda-Alonso Gabriela, Di Paolo Fabio, Shaw Evelyn, Puig-Asensio Mireia
Аннотация
BACKGROUND: Bacterial ventriculitis associated with CSF shunts or drains is a life-threatening infection often caused by MDR pathogens such as Stenotrophomonas maltophilia. Cefiderocol, an IV siderophore cephalosporin approved for drug-resistant Gram-negative infections, lacks extensive clinical data supporting its use in CNS infections.
OBJECTIVES: We describe a case of S. maltophilia ventriculitis successfully treated with cefiderocol monotherapy at a standard dose of 2 g IV every 8 h. Data on cefiderocol CSF drug penetration are reported.
METHODS: Cefiderocol trough plasma and CSF concentrations (C min) were determined at steady-state conditions, and S. maltophilia susceptibility testing was determined using Etest and disc diffusion.
RESULTS: Therapeutic drug monitoring showed sustained CSF cefiderocol concentrations. CSF cefiderocol C min remained 116.0- and 131.8-fold above the isolate's MIC throughout the dosing interval, with plasma-to-CSF penetration ratios of 16.6%-25.7%. Patient's clinical cure was achieved after 26 days of therapy without adverse events or relapse at 1 year of follow-up.
CONCLUSIONS: Our data show that cefiderocol at a standard dose of 2 g IV every 8 h achieved sustained therapeutic concentrations in the CSF. Cefiderocol monotherapy may be an option for CNS infections with MDR Gram-negative bacteria with low MICs such as S. maltophilia.
OBJECTIVES: We describe a case of S. maltophilia ventriculitis successfully treated with cefiderocol monotherapy at a standard dose of 2 g IV every 8 h. Data on cefiderocol CSF drug penetration are reported.
METHODS: Cefiderocol trough plasma and CSF concentrations (C min) were determined at steady-state conditions, and S. maltophilia susceptibility testing was determined using Etest and disc diffusion.
RESULTS: Therapeutic drug monitoring showed sustained CSF cefiderocol concentrations. CSF cefiderocol C min remained 116.0- and 131.8-fold above the isolate's MIC throughout the dosing interval, with plasma-to-CSF penetration ratios of 16.6%-25.7%. Patient's clinical cure was achieved after 26 days of therapy without adverse events or relapse at 1 year of follow-up.
CONCLUSIONS: Our data show that cefiderocol at a standard dose of 2 g IV every 8 h achieved sustained therapeutic concentrations in the CSF. Cefiderocol monotherapy may be an option for CNS infections with MDR Gram-negative bacteria with low MICs such as S. maltophilia.