<i>In vitro</i>evolution of cefepime/zidebactam (WCK 5222) resistance in<i>Pseudomonas aeruginosa</i>: dynamics, mechanisms, fitness trade-off and impact on<i>in vivo</i>efficacy

Abstract

Development of cefepime/zidebactam resistance in P. aeruginosa required multiple simultaneous mutations that were associated with a significant impairment of fitness and virulence.