Management of an infection from NDM-1-producing Escherichia coli with susceptibility to aztreonam

November 17, 2025
Case Report
Alison M Hixon, Sumanth Gandra, Rebekah E Dumm
Pathogen:Escherichia coli
Infection Type:Bacterial infection
Pathogen Type:Bacteria

Summary

A patient presented with an infection caused by NDM-1-producing Escherichia coli, a carbapenem-resistant Enterobacterales strain increasingly reported in the US. Diagnostic methods confirmed the presence of NDM-1, and surprisingly, the isolate demonstrated susceptibility to aztreonam. This finding allowed for targeted monotherapy with aztreonam, which successfully managed the infection. The case highlights a crucial therapeutic option for these highly resistant pathogens, where conventional treatments are often ineffective. Understanding the nuances of antimicrobial susceptibility, even in multidrug-resistant organisms, is vital for effective patient care and combating antibiotic resistance.

Key note: Aztreonam can be an effective monotherapy for NDM-1-producing E. coli infections if susceptibility is confirmed.

DOI: 10.1128/asmcr.00173-25