Optimizing target inactivation to treat multidrug-resistant Escherichia coli with NDM and PBP3 mutations: “going the extra mile”

Antimicrobial Agents and Chemotherapy 2026 Open access

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Authors: Claudia Fabrizio, Felice Valzano, Simone Giuliano, Elisabetta Morelli, Daniela Serio, Giovanni Battista Buccoliero, Maurizio Cervellera, Gianfranco La Bella, Fabio Arena, Andrea M. Hujer, Magdalena A. Taracila, Steven Marshall
+2 more Robert A. Bonomo, Carlo Tascini
DOI: 10.1128/aac.00887-25
Cited by: 6
References: 19

Abstract

ABSTRACT A 65-year-old man without identifiable risk factors for multidrug-resistant pathogens was admitted with peritonitis, isolating NDM-producing Escherichia coli from a rectal swab and intraoperative samples. After surgery, ceftazidime-avibactam/aztreonam was administered. Due to poor clinical response, he was switched to imipenem-relebactam/aztreonam, resulting in a successful outcome. Whole-genome sequencing detected bla NDM-5 and bla CMY-148 β-lactamases, PBP3 YRIN insertion, and mutated cirA gene. This case illustrates the importance of considering different mechanisms of resistance when choosing combination therapy.

Fields of Study & Subjects

Antibiotic Resistance in Bacteria Escherichia coli research studies Immune Response and Inflammation

Publication details

Journal / source
Antimicrobial Agents and Chemotherapy
Publisher
American Society for Microbiology
Volume
70
Issue
5
Pages
e0088725–e0088725
Publication date
20 February 2026
Language
EN