Activity of cefepime/zidebactam against MDR <i>Escherichia coli</i> isolates harbouring a novel mechanism of resistance based on four-amino-acid inserts in PBP3

Abstract

E. coli isolates concurrently harbouring four-amino-acid inserts in PBP3 and NDM are an emerging therapeutic challenge. Assisted by the PBP2-binding action of zidebactam, the cefepime/zidebactam combination overcomes both target modification (PBP3 insert)- and carbapenemase (NDM)-mediated resistance mechanisms in E. coli.