# Cefiderocol-Resistant Elizabethkingia anophelis Bacteremia Following WATCHMAN Implantation: A Case Report and Review of the Literature

## TL;DR

This paper reports the first case of cefiderocol-resistant Elizabethkingia anophelis bacteremia after a WATCHMAN implantation, highlighting the challenges of treating this drug-resistant pathogen.

## Contribution

The first reported case of cefiderocol resistance in Elizabethkingia spp., expanding the known resistance profile of this emerging pathogen.

## Key findings

- A case of cefiderocol-resistant Elizabethkingia anophelis bacteremia was identified following WATCHMAN implantation.
- This is the first documented instance of cefiderocol resistance in Elizabethkingia species.
- The case underscores the growing challenge of antibiotic resistance in treating E. anophelis infections.

## Abstract

Elizabethkingia anophelis is an emerging pathogen associated with nosocomial and community outbreaks. Treatment of infection caused by E. anophelis is not well-defined given its extensive drug resistance profile, and infection carries a poor prognosis. E. anophelis is intrinsically resistant to many classes of antibiotics including carbapenems and polymyxins due to multiple resistance genes. Resistance to novel β-lactam/β-lactamase inhibitors has also been reported. The activity of cefiderocol (FDC) is unknown. Here, we describe a case of FDC-resistant E. anophelis bacteremia following WATCHMAN implantation. To our knowledge, this is the first reported case of FDC resistance amongst Elizabethkingia spp.