Project Grant K23AI201893

The National Institute of Allergy and Infectious Diseases awarded The Johns Hopkins University $195,640 on September 1, 2026, under the Allergy and Infectious Diseases Research program (CFDA 93.855) to conduct research integrating genomic and clinical approaches to define and prevent cefiderocol resistance in carbapenem-resistant organisms.

The research addresses gaps in understanding cefiderocol resistance mechanisms and clinical use in carbapenem-resistant organisms, which cause severe infections with mortality approaching 40 percent. The project pursues three integrated aims: defining U.S. epidemiology of cefiderocol susceptibility through broth microdilution testing on approximately 1,000 consecutive carbapenem-resistant organism isolates and short- and long-read sequencing on paired pre- and post-therapy isolates from approximately 200 patients to generate hybrid assemblies and investigate resistance emergence mechanisms; developing a clinical decision tree to identify host, treatment, and microbial factors associated with resistance emergence and provide clinicians with guidance on optimal cefiderocol use; and evaluating comparative effectiveness of cefiderocol versus beta-lactam/beta-lactamase inhibitor agents in approximately 850 adults with carbapenem-resistant organism infections using advanced causal inference methods.

Performance occurs in Baltimore, Maryland, with a period of performance from September 1, 2026, through August 31, 2031. This is a project grant under the Allergy and Infectious Diseases Research program, which supports biomedical research and research training in infectious diseases and related areas.