European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
Treatment of post-lung transplantation pneumonia with cefiderocol: a case series and insights from the literature.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Giuliano Gabriele, Lippi Arianna, Sambo Margherita, Dulislami Laerta, Zanchi Marta, Bennett David, Fossi Antonella, Michielon Alberto, Marianello Daniele, Puddu Antonella, Catelli Chiara, Paladini Piero, Luzzi Luca, Cusi Maria Grazia, Fabbiani Massimiliano, Franchi Federico, Tumbarello Mario, Montagnani Francesca
Аннотация
BACKGROUND: Post-lung transplantation pneumonia (pLuTP) is among the most frequent complications following lung transplantation, predominantly caused by Gram-negative bacteria (GNB). The emergence of multidrug-resistant (MDR) non-fermenting GNB as aetiological agents of pLuTP represents a major therapeutic challenge due to limited treatment options.
METHODS: We present a retrospective case series describing 20 episodes of pLuTP successfully treated with cefiderocol.
RESULTS: Thirteen patients, with a median age of 56 years (IQR 44-59), experienced a total of 20 episodes of pLuTP. In 3 cases (25.0%), polymicrobial pneumonia was diagnosed. Acinetobacter baumannii was isolated in 13/20 episodes (65.0%), followed by Pseudomonas aeruginosa (6/20, 30.0%), Achromobacter xylosoxidans and Klebsiella pneumoniae (2/20, 10.0% each). Cefiderocol was administered in all episodes: as monotherapy in 5/20 cases (25.0%), in combination with high-dose ampicillin/sulbactam in 7/20 cases (35.0%), aminoglycosides or intravenous colistin (2/20, 10.0% each), and other regimens in the remaining 4/20 cases (20.0%). Clinical cure was achieved in 17/20 cases (85.0%). Microbiological eradication was not achieved in any case. Relapse occurred in 4/20 episodes (20.0%), with no evidence of in vitro cefiderocol resistance. No major adverse events were reported.
CONCLUSIONS: Cefiderocol may represent a valuable therapeutic option for managing pLuTP caused by difficult-to-treat GNB in lung transplant recipients.
METHODS: We present a retrospective case series describing 20 episodes of pLuTP successfully treated with cefiderocol.
RESULTS: Thirteen patients, with a median age of 56 years (IQR 44-59), experienced a total of 20 episodes of pLuTP. In 3 cases (25.0%), polymicrobial pneumonia was diagnosed. Acinetobacter baumannii was isolated in 13/20 episodes (65.0%), followed by Pseudomonas aeruginosa (6/20, 30.0%), Achromobacter xylosoxidans and Klebsiella pneumoniae (2/20, 10.0% each). Cefiderocol was administered in all episodes: as monotherapy in 5/20 cases (25.0%), in combination with high-dose ampicillin/sulbactam in 7/20 cases (35.0%), aminoglycosides or intravenous colistin (2/20, 10.0% each), and other regimens in the remaining 4/20 cases (20.0%). Clinical cure was achieved in 17/20 cases (85.0%). Microbiological eradication was not achieved in any case. Relapse occurred in 4/20 episodes (20.0%), with no evidence of in vitro cefiderocol resistance. No major adverse events were reported.
CONCLUSIONS: Cefiderocol may represent a valuable therapeutic option for managing pLuTP caused by difficult-to-treat GNB in lung transplant recipients.