Inhibitor of the NDM Enzyme
Aspergillomarasmine (AMA) was identified as an inhibitor of the New Delhi
metallo-betalactamase (NDM) enzyme. This substance, when combined with meropenem, restored antibiotic activity against an NDM lab strain. AMA is a substance which was already tested in the past in humans. Concerns about interference with human metalloenzymes proved unfounded; it seems to have negligible toxicity. Currently, only colistin is active against NDM bacteria. None of the newer B-lactamase inhibitors (avibactam, MK-7655) inactivates NDMs.
Of note, tigecycline has poor activity against NDM-producers. 
Altered Antibiotic PK in Critically Ill Patients Requires Dosing Adjustments
Cefuroxime dosing, like that of other B-lactams, needs to be adjusted upwards in critically ill ICU patients. Especially when CLcr is in the normal range, standard doses are unlikely to achieve levels of T > MIC of 65% or greater. Hence, pathogens with MICs close to break point or patients with high CLcr may not be adequately covered with intermittent dosing. Based on PK/PD data, a continuous infusion of high doses may be able to still provide bacterial killing. As the authors point out, clinical studies to confirm this approach have yet to be performed.
First Case of Ciprofloxacin-Resistant Legionella pneumophila
I guess it had to happen eventually: Bruin et al. report a patient infected with
L. pneumophila serogroup 1 who presented with severe respiratory insufficiency and interstial pneumonia. The organism MIC – tested at a reference lab – was 2 mg/L. Sequencing of the gyrA gene revealed a point mutation in the QRDR (quinolone resistance determining region). It was not clear whether the organism was resistant already prior to ciprofloxacin therapy.