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“Stormy waters ahead”: global emergence of carbapenemases

Gopi Patel, Robert A. Bonomo

Frontiers in Microbiology · 2013

doi:10.3389/fmicb.2013.00048

Abstract

Carbapenems, once considered the last line of defense against of serious infections with Enterobacteriaceae, are threatened with extinction. The increasing isolation of carbapenem-resistant Gram-negative pathogens is forcing practitioners to rely on uncertain alternatives. As little as 5 years ago, reports of carbapenem resistance in Enterobacteriaceae, common causes of both community and healthcare-associated infections, were sporadic and primarily limited to case reports, tertiary care centers, intensive care units, and outbreak settings. Carbapenem resistance mediated by β-lactamases, or carbapenemases, has become widespread and with the paucity of reliable antimicrobials available or in development, international focus has shifted to early detection and infection control. However, as reports of Klebsiella pneumoniae carbapenemases, New Delhi metallo-β-lactamase-1, and more recently OXA-48 (oxacillinase-48) become more common and with the conveniences of travel, the assumption that infections with highly resistant Gram-negative pathogens are limited to the infirmed and the heavily antibiotic and healthcare exposed are quickly being dispelled. Herein, we provide a status report describing the increasing challenges clinicians are facing and forecast the "stormy waters" ahead.

Full text

From PubMed Central, U.S. National Library of Medicine, as current on Oct 18, 2026. Paragraph numbers are ours, so an answer can point at one.

1Carbapenems are potent and broad-spectrum β-lactam antibiotics traditionally reserved for the treatment of the most serious infections. The emergence and dissemination of carbapenem-resistant Gram-negative pathogens including Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae is a significant contributor to patient morbidity and mortality. Despite radical efforts in infection control and improvements in rapid molecular diagnostics, carbapenem-resistant Gram-negative bacilli remain a formidable threat as few antimicrobial agents are reliably active and very little is expected to be available in the near future.

2Clinicians hold that the increasing prevalence of extended-spectrum β-lactamases (ESBLs) among Klebsiella pneumoniae and Escherichia coli in the 1980s and 1990s contributed to the increased consumption of carbapenems. Experience implied that delayed administration of carbapenems in at-risk patients led to poor clinical outcomes. Thus, carbapenems (i.e., imipenem, meropenem, ertapenem, and doripenem) became vital tools in the treatment of healthcare-associated and severe community-acquired infections. Despite heavy reliance on these agents, carbapenem resistance in Enterobacteriaceae, common causes of both community and healthcare-associated infections, remained rare until the past decade.

3Carbapenem resistance among Gram-negative bacteria results from one or more of the following mechanisms: (i) hyperproduction or derepression of Ambler class C β-lactamases (AmpC β-lactamases) or ESBLs (e.g., sulfhydryl variable (SHV), temoneira (TEM), cefotaxime (CTX-M) type β-lactamases) with loss or alteration in outer membrane porins; (ii) augmented drug efflux; (iii) alterations in penicillin binding proteins (PBPs); (iv) carbapenemase production. Carbapenemases belong to three molecular classes of β-lactamases, Ambler class A, B, and D. Our aim is to provide a status report of the molecular diversity and epidemiology of carbapenemases as well as current and future therapeutics. The increasing public safety concerns associated with organisms harboring these enzymes has created significant turmoil. Regrettably, the situation is critical and our patients are in peril.

AMBLER CLASS A CARBAPENEMASES

4Few Ambler class A β-lactamases demonstrate carbapenem-hydrolyzing activity and, up until a decade ago, these were rarely recovered. Class A carbapenemases include: K. pneumoniae carbapenemase (KPC), Guiana extended-spectrum (GES), non-metallo-carbapenemase-A (Nmc-A)/imipenem-resistant (IMI), Serratia marcescens enzyme (SME), serratia fonticola carbapenemase (SFC), and BIC β-lactamases (Table 1; ). With the notable exception of KPCs, the clinical isolation of these types of carbapenemases is relatively limited.

5Non-metallo-carbapenemase-A is a chromosomal carbapenemase originally isolated from Enterobacter cloacae in France. Currently, reports of this particular β-lactamase are still rare. IMI-1 was initially recovered from the chromosome of an Enterobacter cloacae isolate in the southwestern USA. A variant of IMI-1, IMI-2, has been identified on plasmids isolated from environmental strains of Enterobacter asburiae in USA rivers.

6SME-1 (S. marcescens enzyme) was originally identified in an isolate of S. marcescens from a patient in London in 1982. SME-2 and SME-3 were subsequently isolated in the USA, Canada, and Switzerland. Chromosomally encoded SME-type carbapenemases continue to be isolated at a low frequency in North America. Both SFC-1 and BIC-1 are chromosomal serine carbapenemases recovered from environmental isolates. The former from a S. fonticola isolate in Portugal and the latter from Pseudomonas fluorescens isolates recovered from the Seine River.

7The GES-type β-lactamases are acquired β-lactamases recovered from P. aeruginosa, Enterobacteriaceae, and A. baumannii. The genes encoding these β-lactamase have often, but not exclusively, been identified within class 1 integrons residing on transferable plasmids. GES-1 has a similar hydrolysis profile to other ESBLs, although they essentially spare monobactams. Several GES β-lactamases are described with six (i.e., GES-2, GES-4, GES-5, GES-6, GES-11, and GES-14), demonstrating detectable carbapenemase activity in the setting of amino acid substitutions at their active sites (specifically at residue 104 and 170;; ). These GES-type carbapenemases have been described in Europe, South Africa, Asia, and the Middle East.

8Currently, most carbapenem resistance among Enterobacteriaceae in the USA and Israel is attributed to plasmid-mediated expression of a KPC-type carbapenemase. KPC-producing Enterobacteriaceae are considered endemic to Greece along with other carbapenemases, specifically VIM-type [Verona integron-encoded metallo-β-lactamases (MBLs); ]. KPCs efficiently hydrolyze carbapenems as well as penicillins, cephalosporins, and aztreonam and are not overcome in vitro by clinically available β-lactamase inhibitors (i.e., clavulanic acid, sulbactam, tazobactam – in fact these are hydrolyzed). These enzymes have been identified in several genera of Enterobacteriaceae as well as Pseudomonas spp. and A. baumannii.

9Carbapenem resistance secondary to KPC production was first described in a K. pneumoniae recovered in North Carolina in 1996. To date 12 KPC subtypes (KPC-2 to KPC-13;;;;; ) have been reported with the vast majority of analyzed isolates expressing either KPC-2 or KPC-3.

10The blaKPC gene has been mapped to a highly conserved Tn3-based transposon, Tn4401 (Figure 1A), and five isoforms of Tn4401 are described. Plasmids carrying blaKPC are of various sizes and many carry additional genes conferring resistance to fluoroquinolones and aminoglycosides thus limiting the antibiotics available to treat infections with KPC-producing pathogens. blaKPC has rarely been mapped to a chromosomal location.

11A predominant strain of K. pneumoniae appears responsible for outbreaks and the international spread of KPC-producing K. pneumoniae. Congruent pulsed-field gel electrophoresis (PFGE) patterns also suggest a clonal relationship between outbreak-associated strains of KPC-producing K. pneumoniae recovered from different areas that are endemic. The Centers for Disease Control and Prevention (CDC) performed PFGE and multilocus sequence typing (MLST) on isolates submitted to their reference laboratory from 1996 to 2008. A dominant PFGE pattern was observed and noted to be of a specific MLST type, ST 258. A second sequence type, ST 14, was common in institutions in the Midwest. These findings implied that certain strains of K. pneumoniae may be more apt to obtain and retain the blaKPC gene. Another study, however, analyzing 16 KPC-2 producing K. pneumoniae isolates from different geographic regions demonstrated diverse PFGE patterns and MLST types. This included four different MLST types in Colombia (ST 14, ST 337, ST 338, and ST 339) and two in Israel (ST 227 and ST 340). Although this study analyzed a smaller number of isolates, these findings suggest that the global propagation of KPC-2 is more complicated than the successful expansion of a fixed number of clones. More recently, a study evaluating the MLST types associated with widespread KPC-2 production in K. pneumoniae in Greece suggested that although ST 258 predominates at least 10 additional sequence types were found to carry blaKPC-2. Of note three (i.e., ST 147, ST 323, and ST 383) carried both KPC-2 as well as genes encoding VIM-type MBLs. A retrospective study in Cleveland documented the presence of ST 36 in a long-term care facility for children.

12Klebsiella pneumoniae carbapenemases-production can confer variable levels of carbapenem resistance with reported minimum inhibitory concentrations (MICs) ranging from susceptible to ≥ μg/mL. Analysis of isolates displaying high-level carbapenem resistance demonstrated that increased phenotypic resistance may be due to increased blaKPC gene copy number or the loss of an outer membrane porin, OmpK35 and/or OmpK36. The highest level of imipenem resistance was seen with isolates lacking both porins and with augmented KPC enzyme production.

AMBLER CLASS B CARBAPENEMASES: METALLO-β-LACTAMASES

13Class B β-lactamases (Table 2) are referred to as MBLs and require a metal ion, usually zinc, for β-lactam hydrolysis. Due to the dependence on Zn2+, catalysis is inhibited in the presence of metal-chelating agents like ethylenediaminetetraacetic acid (EDTA). MBL expression in Gram-negative bacteria confers resistance to penicillins, cephalosporins, and carbapenems. MBLs are not inhibited by the presence of commercially available β-lactamase inhibitors and susceptibility to monobactams (e.g., aztreonam) appears to be preserved in the absence of concomitant expression of other resistance mechanisms (e.g., ESBL production). The more geographically widespread MBLs include IMP (imipenem-resistant), VIM, and New Delhi metallo-β-lactamase (NDM).

14Chromosomal MBLs were the first to be identified and are the cause of carbapenem resistance observed in Bacillus cereus, Aeromonas spp., and Stenotrophomonas maltophilia. However, of growing concern are the “mobile” MBLs that have been reported since the mid-1990s. Although most frequently found in carbapenem-resistant isolates of P. aeruginosa and occasionally Acinetobacter spp., there is growing isolation of these enzymes in Enterobacteriaceae.

15Prior to the description of NDM-1, frequently detected MBLs include IMP-type and VIM-type with VIM-2 being the most prevalent. These MBLs are embedded within a variety of genetic structures, most commonly integrons. When these integrons are associated with transposons or plasmids they can readily be transferred between species.

16In 1991, IMP-1, a plasmid-mediated MBL, was identified in an isolates of S. marcescens from Japan. Since then plasmid-mediated carbapenem resistance secondary to IMP-1 spread widely in Japan, Europe, Brazil, and other parts of Asia and in several species of Gram-negative bacilli including Acinetobacter spp. and Enterobacteriaceae. At the present time, 42 variants of IMP have been identified with most cases of IMP-mediated carbapenem resistance being reported from Asia and among P. aeruginosa.

17A more commonly recovered MBL is the VIM-type enzyme. VIM-1 was first described in Italy in 1997 in P. aeruginosa. VIM-2 was next discovered in southern France in P. aeruginosa cultured from a neutropenic patient in 1996. Although originally thought to be limited to non-fermenting Gram-negative bacilli, VIM-type MBLs are being increasingly identified in Enterobacteriaceae as well. To date, 37 variants of VIM have been described with VIM-2 being the most common MBL recovered worldwide.

18Other more geographically restricted MBLs include SPM-1 (Sao Paulo MBL), which has been associated with hospital outbreaks in Brazil; GIM-1 (German imipenemase) isolated in carbapenem-resistant P. aeruginosa isolates in Germany; SIM-1 (Seoul imipenemase) isolated from A. baumannii isolates in Korea; KHM-1 (Kyorin Health Science MBL) isolated from a C. freundii isolate in Japan; AIM-1 (Australian imipenemase) isolated from P. aeruginosa in Australia; DIM-1 (Dutch imipenemase) isolated from a clinical P. stutzeri isolate in the Netherlands; SMB-1 (S. marcescens MBL) in S. marcescens in Japan; TMB-1 (Tripoli MBL) in Achromobacter xylosoxidans in Libya, and FIM-1 (Florence imipenemase) from a clinical isolate of P. aeruginosa in Italy. With the notable exception of SPM-1, these MBLs have remained confined to their countries of origin.

19NDM-1 was first identified in 2008. Due to its rapid international dissemination and its ability to be expressed by numerous Gram-negative pathogens, NDM is poised to become the most commonly isolated and distributed carbapenemase worldwide. Initial reports frequently demonstrated an epidemiologic link to the Indian subcontinent where these MBLs are endemic. Indeed, retrospective analyses of stored isolates suggest that NDM-1 may have been circulating in the subcontinent as early as 2006. Despite initial controversy, the Balkans may be another area of endemicity for NDM-1. Sporadic recovery of NDM-1 in the Middle East suggests that this region may be an additional reservoir.

20Like KPCs, the conveniences of international travel and medical tourism have quickly propelled this relatively novel MBL into a formidable public health threat. Gram-negative bacilli harboring blaNDM have been identified worldwide with the exception of Central and South America.

21NDM-1 was first identified in Sweden in a patient of Indian descent previously hospitalized in India. The patient was colonized with a K. pneumoniae and an E. coli carrying blaNDM-1 on transferable plasmids. In the UK, an increase in the number of clinical isolates of carbapenem-resistant Enterobacteriaceae was seen in both 2008 and 2009. A UK reference laboratory reported that at least 17 of 29 patients found to be harboring NDM-1 expressing Enterobacteriaceae had a history of recent travel to the Indian subcontinent with the majority having been hospitalized in those countries.

22European reports suggest that horizontal transfer of blaNDM-1 exists within hospitals outside endemic areas. Of overwhelming concern are the reported cases without specific contact with the healthcare system locally or in endemic areas suggesting autochthonous acquisition.

23Surveillance of public water supplies in India indicates that exposure to NDM-1 may be environmental. analyzed samples of public tap water and seepage water from sites around New Delhi. The results were disheartening in that blaNDM-1 was detected by PCR in 4% of drinking water samples and 30% of seepage samples. In this survey, carriage of blaNDM-1 was noted in 11 species of bacteria not previously described, including virulent ones like Shigella boydii and Vibrio cholerae.

24The rapid spread of NDM-1 highlights the fluidity and rapidity of gene transfer between bacterial species. Although blaNDM-1 was initially and repeatedly mapped to plasmids isolated from carbapenem-resistant E. coli and K. pneumoniae, reports of both plasmid and chromosomal expression of blaNDM-1 has been noted in other species of Enterobacteriaceae as well as Acinetobacter spp. and P. aeruginosa. Recently, bacteremia with a NDM-1 expressing V. cholerae has been described in a patient previously hospitalized in India colonized with a variety of Enterobacteriaceae previously known to be capable of carrying plasmids with blaNDM-1.

25In contrast to KPCs, the presence of a dominant clone among blaNDM-1 carrying isolates remains elusive. NDM-1 expression in E. coli has been noted among sequence types previously associated with the successful dissemination of other β-lactamases including ST 101 and ST 131. analyzed a relatively large group of blaNDM-1 expressing E. coli from the UK, Pakistan, and India in order to potentially identify a predominant strain responsible for the rapid and successful spread of NDM-1. The most frequent sequence type identified was ST 101. Another study examining a collection of carbapenem-resistant Enterobacteriaceae from India demonstrates the diversity of strains capable of harboring blaNDM-1. Carriage of blaNDM-1 was confirmed in 10 different sequence types of K. pneumoniae and 5 sequence types of E. coli. This multiplicity was confirmed in a study looking at a collection of blaNDM-1 expressing Enterobacteriaceae from around the world. Of most concern is that NDM-1 has been identified in E. coli ST 131, the strain of E. coli credited with the global propagation of CTX-M-15 ESBLs. Similar to KPCs, NDM-1 expression portends variable levels of carbapenem resistance and there is often concomitant carriage of a myriad of resistance determinants including other β-lactamases and carbapenemases as well as genes associated with resistance to fluoroquinolones and aminoglycosides.

26NDM-1 shares the most homology with VIM-1 and VIM-2. It is a 28-kDa monomeric protein that demonstrates tight binding to both penicillins and cephalosporins. Binding to carbapenems does not appear to be as strong as other MBLs, but hydrolysis rates appear to be similar. Using ampicillin as a substrate, allowed for detailed characterization of the interactions between NDM's active site and β-lactams as well as improved evaluation of MBLs unique mechanism of β-lactam hydrolysis. More recent crystal structures of NDM-1 reveal the molecular details of how carbapenem antibiotics are recognized by dizinc-containing MBLs.

27To date, NDM-1 remains the most common NDM variant isolated. Seven variants (NDM-1 to NDM-7) exist. It is currently held that blaNDM-1 is a chimeric gene that may have evolved from A. baumannii. Contributing to this theory is the presence of complete or variations of the insertion sequence, ISAba125, upstream to the blaNDM-1 gene in both Enterobacteriaceae and A. baumannii. This insertion sequence has primarily been found in A. baumannii.

28A recent evaluation of the genetic construct associated with blaNDM-1 (Figure 1B) has lead to the discovery of a new bleomycin resistance protein, BRPMBL. Evaluation of 23 isolates of blaNDM-1/2 harboring Enterobacteriaceae and A. baumannii noted that the overwhelming majority of them possessed a novel bleomycin resistance gene, bleMBL. Co-expression of blaNDM-1 and bleMBL appear to be mediated by a common promoter (PNDM-1) which includes portions of ISAba125. It is postulated that BRPMBL expression may contribute some sort of selective advantage allowing NDM-1 to persist in the environment.

29A contemporary evaluation of recently recovered NDM-1 producing A. baumannii isolates from Europe demonstrates that blaNDM-1 and blaNDM-2 genes are situated on the same chromosomally located transposon, Tn125. Dissemination of blaNDM in A. baumannii seems be due to different strains carrying Tn125 or derivatives of Tn125 rather than plasmid-mediated or clonal.

CARBAPENEM-HYDROLYZING CLASS D β-LACTAMASES

30Oxacillinases comprise a heterogeneous group of class D β-lactamases which are able to hydrolyze amino- and carboxypenicillins. The majority of class D β-lactamases are not inhibited by commercially available β-lactamase inhibitors but are inhibited in vitro by NaCl. Over 250 types of oxacillinases are reported with a minority demonstrating low levels of carbapenem-hydrolyzing activity. This select group of enzymes is also referred to as the carbapenem-hydrolyzing class D β-lactamases (CHDLs; Table 3). CHDLs have been identified most frequently in Acinetobacter spp., however, there has been increasing isolation among Enterobacteriaceae, specifically OXA-48 (oxacillinase-48;; ).

31With the exception of OXA-163, CHDLs efficiently inactivate penicillins, first generations cephalosporins, and β-lactam/β-lactamase inhibitor combinations, but spare extended-spectrum cephalosporins. Carbapenem hydrolysis efficiency is lower than that of other carbapenemases, including the MBLs, and often additional resistance mechanisms are expressed in organisms demonstrating higher levels of phenotypic carbapenem resistance. These include expression of other carbapenemases, alterations in outer membrane proteins (e.g., CarO, OmpK36;;; ), increased transcription mediated by IS elements functioning as promoters, increased gene copy number, and amplified drug efflux. Many subgroups of CHDLs have been described. We will focus on those found in A. baumannii and Enterobacteriaceae: OXA-23 and OXA-27; OXA-24/40, OXA-25, and OXA-26; OXA-48 variants; OXA-51, OXA-66, OXA-69; OXA-58, and OXA-143.

32CHDLs can be intrinsic or acquired. A. baumannii does have naturally occurring but variably expressed chromosomal CHDLs, OXA-51, OXA-66, and OXA-69. For the most part, in isolation the phenotypic carbapenem resistance associated with these oxacillinases is low. However, levels of carbapenem resistance appear to be increased in the presence of specific insertion sequences promoting gene expression. Additional resistance to extended-spectrum cephalosporins can be seen in the setting of co-expression of ESBLs and/or other carbapenemases.

33The first reported “acquired” oxacillinase with appreciable carbapenem-hydrolyzing activity was OXA-23. OXA-23, or ARI-1, was identified from an A. baumannii isolate in Scotland in 1993 (the isolate was first recovered in 1985; ). Subsequently, OXA-23 expression has been reported worldwide and both plasmid and chromosomal carriage of blaOXA-23 are described. The OXA-23 group includes OXA-27, found in a single A. baumannii isolate from Singapore. With the exception of an isolate of Proteus mirabilis identified in France in 2002, this group of β-lactamases has been exclusively recovered from Acinetobacter species. Increased expression of OXA-23 has been associated with the presence of upstream insertion sequences (e.g., ISAba1 and ISAba4) acting as strong promoters.

34Another group of CHDLs include OXA-24/40, OXA-25, and OXA-26. OXA-24 and OXA-40 differ by a few amino acid substitutions and OXA-25 and OXA-26 are point mutation derivatives of OXA-40. Although primarily linked with clonal outbreaks in Spain and Portugal, OXA-24/40 β-lactamases has been isolated in other European countries and the USA. OXA-40 was in fact the first CHDL documented in the USA.

35OXA-58 has also only been detected in Acinetobacter spp. initially identified in France, OXA-58 has been associated with institutional outbreaks and has been recovered from clinical isolates of A. baumannii worldwide.

36As civilian and military personnel began returning from Afghanistan and the Middle East, practitioners noted increasing recovery of A. baumannii from skin and soft tissue infections. Drug resistance was associated with expression of both OXA-23 and OXA-58. Many isolates carrying the blaOXA-58 gene concurrently carry insertion sequences (e.g., ISaba1, ISAba2, or ISAba3) associated with increased carbapenemase production and thus higher levels of carbapenem resistance. In one report increased gene copy number was also associated with a higher level of enzyme production and increased phenotypic carbapenem resistance.

37Spread of OXA-type carbapenemases among A. baumannii appears to be clonal and in depth reviews of the molecular epidemiology and successful dissemination of these clones have been published. Two MLST schemes with three loci in common exist for A. baumannii – the PubMLST scheme and the Pasteur scheme. Both schemes assign different sequence types into clonal complexes (CC). Sequence types and CC from both schemes can be further categorized into the international (European) clones I, II, and III. It should be noted, however, that the molecular taxonomy of A. baumannii continues to evolve. OXA-23 producing A. baumannii predominantly belong to international clones I and II with a notable proportion being part of CC92 (PubMLST;; ). Similarly, A. baumannii isolates associated with epidemic spread of OXA-24/40 in Portugal and Spain appear are incorporated in international clone II and ST 56 (PubMLST; ). OXA-58 expressing A. baumannii have been associated with international clones I, II, and II and a variety of unrelated sequence types.

38OXA-48 was originally identified in a carbapenem-resistant isolate of K. pneumoniae in Turkey. Early reports suggested that this enzyme was geographically restricted to Turkey. In the past few years, however, the enzyme has been recovered from variety of Enterobacteriaceae and has successfully circulated outside of Turkey with reports of isolation in the Middle East, North Africa, Europe, and most recently the USA. The Middle East and North Africa may be secondary reservoirs for these CHDLs. Indeed, the introduction of OXA-48 expressing Enterobacteriaceae in some countries has been from patients from the Middle East or Northern Africa. In the USA, the first clinical cases were associated with ST 199 and ST 43.

39At least six OXA-48 variants (e.g., OXA-48, OXA-162, OXA-163, OXA-181, OXA-204, and OXA-232) have been identified. OXA-48 is by far the most globally dispersed and its epidemiology has been recently reviewed. Unlike KPCs and NDM-1 which have been associated with a variety of plasmids, a single 62 kb self-conjugative IncL/M-type plasmid has contributed to a large proportion of the distribution of blaOXA-48 in Europe. Sequencing of this plasmid (pOXA-48a) notes that blaOXA-48 had been integrated through the acquisition of a Tn1999 composite transposon (Figure 1C; ) blaOXA-48 appears to be associated with a specific insertion sequence, IS1999. A variant of Tn1999, Tn1999.2, has been identified among isolates from Turkey and in Europe. Tn1999.2 harbors an IS1R element within the IS1999. OXA-48 appears to have the highest affinity for imipenem of the CHDLs specifically those harboring blaOXA-48 within a Tn1999.2 composite transposon. Three isoforms of the Tn1999 transposon have been described.

40Although much of the spread of OXA-48 is attributed to a specific plasmid, outbreak evaluations demonstrate that a variety of strains have contributed to dissemination of this emerging carbapenemase in K. pneumoniae. The same K. pneumoniae sequence type, ST 395, harboring blaOXA-48 was identified in Morocco, France, and the Netherlands. ST 353 was associated with an outbreak of OXA-48 producing K. pneumoniae in London and ST 221 with an outbreak of OXA-48 in Ireland. OXA-48 production in K. pneumoniae, like KPC-expressing K. pneumoniae, has also been associated with ST 14 and a recent outbreak in Greece was associated with ST 11.

41blaOXA-48 is remarkably similar to blaOXA-54, a β-lactamase gene intrinsic to Shewanella oneidensis. Shewanella spp. are relatively ubiquitous waterborne Gram-negative bacilli and are proving to be a potential environmental reservoir for OXA-48 like carbapenemases as well as other resistance determinants.

42OXA-163, a single amino acid variant of OXA-48, was identified in isolates of K. pneumoniae and Enterobacter cloacae from Argentina and is unique in that it has activity against extended-spectrum cephalosporins. OXA-163 also has been identified in Egypt, which has a relatively prevalence of OXA-48, in patients without epidemiologic links to Argentina.

43OXA-181 was initially identified among carbapenem-resistant Enterobacteriaceae collected from India. OXA-181 differs from OXA-48 by four amino acids, however, appears to be nestled in an entirely different genetic platform. The blaOXA-181 gene has been mapped to a different group of plasmids, the ColE family, and has been associated with an alternative insertion sequence, ISEcp1. The latter insertion sequence has been associated with the acquisition of other β-lactamases including CTX-M-like ESBLs. Like, OXA-48, it appears that OXA-181 may have evolved from a waterborne environmental species Shewanella xiamenensis.

44OXA-204 differs from OXA-48 by a two amino acid substitution. It was recently identified in a clinical K. pneumoniae isolate from Tunisia. Its genetic construct appears to be similar to that of OXA-181. OXA-232 was recently identified among K. pneumoniae isolates in France.

45OXA-143 is a novel plasmid-borne carbapenem-hydrolyzing oxacillinase recovered from clinical A. baumannii isolates in Brazil. Information regarding its significance and prevalence continues to evolve.

AVAILABLE AGENTS AND DRUGS IN DEVELOPMENT

46Few antimicrobials are currently available to treat infections with carbapenemase-producing Gram-negative bacteria. Carriage of concurrent resistance determinants can result in decreased susceptibility non-β-lactams including the fluoroquinolones and aminoglycosides thus further compromising an already limited antimicrobial arsenal. What frequently remains available are the polymyxins (including colistin), tigecycline, and fosfomycin but susceptibilities to these agents are unpredictable.

47The reintroduction of polymyxins, both polymyxin B and colistin overlaps with the evolution of carbapenem resistance among Gram-negative bacilli. The clinical “resurgence” of these agents is well documented. Some experts advocate for the use of polymyxins in combination with other agents like rifampicin. In vitro evaluations of different combinations including carbapenems, rifamycins, and/or tigecycline demonstrate variable results. Most evaluations of the clinical outcomes or “effectiveness” of combination therapies have been retrospective. Prospective clinical trials evaluating the superiority of colistin-based combination therapy over monotherapy are in their infancy. A real interest in combination therapy persists due to the concern of hetero-resistance.

48Early evaluations of the glycylcycline, tigecycline, demonstrated favorable in vitro activity against ESBL-producing Enterobacteriaceae and specific isolates of carbapenem-resistant A. baumannii and Enterobacteriaceae. Tigecycline remains untested in prospective trials and reports of resistance are increasing. The role of tigecycline in treating primary bloodstream infections or urinary tract infections remains undefined due less than therapeutic concentrations of drug achieved in the serum and urine. We also note that meta-analyses of pooled data from trials evaluating the use of tigecycline for a variety of indications suggest there is a excess mortality associated with the use of tigecycline over comparator regimens. However, in the absence of other tested regimens tigecycline may be an appropriate or perhaps the only therapeutic option.

49Growing resistance to both the polymyxins and tigecycline has resulted the revisiting of older drugs including chloramphenicol, nitrofurantoin, and temocillin. Fosfomycin is also one of these earlier antibiotics being reassessed. In an in vitro evaluation of 68 KPC-expressing K. pneumoniae isolates, fosfomycin demonstrated in vitro activity against 87% of tigecycline and/or polymyxin non-susceptible isolates and 83% of isolates that were resistant to both. Fosfomycin may be a potential therapeutic option for patients infected with carbapenemase-producing Enterobacteriaceae if the infection is localized to the genitourinary tract. Unfortunately, fosfomycin does not demonstrate reliable activity against non-urinary pathogens. Fosfomycin demonstrated activity against only 30.2% of 1693 multidrug-resistant (MDR) P. aeruginosa isolates and 3.5% of 85 MDR A. baumannii isolates. The individual studies included in this review did not employ uniform MDR definitions or consistent susceptibility breakpoints. Moreover, access to the parenteral fosfomycin is limited and the threshold for resistance is low. Concerns regarding the emergence of resistance have lead to an increasing interest in the utility of combination therapy.

50Few agents are in the advanced stages of development with demonstrable in vitro activity against carbapenemase-producing organisms. These include β-lactamase inhibitors, aminoglycoside derivatives, polymyxin derivatives, and novel monobactams and monobactams-β-lactamase inhibitor combinations.

51Avibactam, or NXL104, is a β-lactamase inhibitor which has been tested in combination with ceftazidime, ceftaroline, and aztreonam against several carbapenemase-producing Enterobacteriaceae with impressive decreases in MICs. Cephalosporin–avibactam combinations do not inhibit MBLs. Avibactam in combination with aztreonam, however, does seem to demonstrate activity against isolates harboring a variety of carbapenem resistance mechanisms including MBLs. Regrettably, the avibactam and aztreonam combination is not currently in clinical trials. The combination of ceftazidime–avibactam has been evaluated against collections of non-fermenting Gram-negative pathogens and its role remains undefined. In some evaluations of ceftazidime non-susceptible isolates of P. aeruginosa decrease MICs were noted with the addition of avibactam. The combinations of ceftaroline–avibactam and ceftazidime–avibactam are currently in clinical trials.

52Methylidene penems (penem-1 and penem-2) are β-lactamase inhibitors and appear to be potent inhibitors of KPC-2. The combination of cefepime with penem-1 demonstrated lower cefepime MICs in 88.1% of the 42 KPC-producing K. pneumoniae isolates evaluated. MK-7655 is a novel β-lactamase being evaluated in combination with imipenem against carbapenem-resistant Gram-negative bacilli.

53ME1071, formerly CP3242, is a maleic acid derivative that competitively inhibits MBLs. Earlier studies demonstrated concentration-dependent decreases in carbapenem MICs in MBL-producing P. aeruginosa, A. baumannii, and select Enterobacteriaceae A contemporary pre-clinical evaluation of ME1071 in combination with various type 2 carbapenems (i.e., biapenem, doripenem, meropenem, imipenem) confirms remarkable decreases in the carbapenem MICs for Enterobacteriaceae and A. baumannii harboring IMP, VIM, and NDM-type MBLs. Irrespective of the candidate carbapenem, ME1071 activity against NDM MBLs was less than that of VIM-type and IMP-type MBLs. Of note, biapenem was the carbapenem with the lowest baseline MICs to the MBLs, but it is commercially unavailable in many countries including the USA. Other MBL-specific inhibitors are in pre-clinical development.

54Plazomicin (ACHN-490) is an aminoglycoside derivative with potent activity against some carbapenem-resistant Gram-negative bacilli. Studies have noted that susceptibilities to aminoglycosides vary among KPC-producing K. pneumoniae. In one evaluation, 48% of 25 tested isolates were susceptible to amikacin, 44% to gentamicin, and 8% to tobramycin. Plazomicin demonstrated an MIC90 significantly lower than that of amikacin. In vitro studies also indicate that depending on the aminoglycoside resistance mechanisms present, Plazomicin may have activity against select isolates of P. aeruginosa and A. baumannii. Susceptibility to plazomicin in the setting of resistance to other aminoglycosides appears to be dependent on the mechanism of aminoglycoside resistance.

55NAB739 and NAB7061 are polymyxin derivatives that may be less nephrotoxic than commercially available polymyxins. In a small in vitro study, NAB739 displayed activity against nine carbapenemase-producing polymyxin-susceptible isolates of Enterobacteriaceae. A contemporary evaluation of NAB739 demonstrated higher MICs compared to those of polymyxin B in a collection of polymyxin-susceptible and non-susceptible Enterobacteriaceae, P. aeruginosa, and A. baumannii. NAB7061 when used in combination with rifampicin or clarithromycin demonstrated synergistic activity against seven strains of carbapenemase-producing Gram-negative bacilli including one polymyxin-resistant strain. It remains unclear what role these agents will play in the setting the increasing burden of infections with carbapenemase-producing Enterobacteriaceae.

56The activity of the siderophore monosulfactam, BAL30072, has been against non-fermenting carbapenemase-producing Gram-negative bacilli. In one study, susceptibility to BAL30072 was noted in 73% of 200 isolates of carbapenemase-producing A. baumannii, the majority of which were of the same OXA-23 producing clone. In that same study, smaller percentages of susceptibility were noted in a selection of carbapenem-resistant Burkholderia cepacia and P. aeruginosa isolates. Recent evaluations of BAL30072 confirm that there may be a role for this agent in the treatment of resistant A. baumannii infections. BAL 30376 is a combination of a siderophore monobactam with clavulanic acid. In two studies, this combination demonstrated reasonable in vitro activity against CHDL, including OXA-48, and MBLs but not KPCs.

CONCLUDING REMARKS

57In the last 5 years, we have witnessed the global spread of carbapenem resistance among Gram-negative organisms. The notion that multidrug resistance among these pathogens is limited to isolated outbreaks among the critically ill has met the ultimate challenge with NDM-1. The conveniences of travel and medical tourism have introduced resistance mechanisms across states, countries, and even continents at an alarming rate. Rates of resistance in some countries may be underestimated due to the lack of organized reporting structures and limited resources. Long-term healthcare facilities are now recognized reservoirs for the continued propagation of MDR organisms.

58Until the introduction of accurate, affordable, and readily accessible diagnostics and reliably effective antimicrobials a major focus remains containment and eradication of these organisms within the healthcare environment. Many cite a “bundle” type approach that includes administrative support, active surveillance, antimicrobial stewardship, and augmented infection control practices. Just as with drug development, the future savings of investing in prevention is not as tangible as the immediate capital investment required to allot appropriate resources including advanced laboratory platforms, experienced laboratory personnel, dedicated nursing staff, and infection control personnel. Expanding these efforts to non-acute healthcare settings is recommended to begin to stem the evolving pandemic of carbapenem resistance.

59The prudent use of antibiotics is essential in combating the continuing evolution of resistance. This may be even more crucial in areas where non-prescription antimicrobial use is common and continues to be unregulated. In an age where multidrug resistance is so widespread, even the appropriate use of broad-spectrum antibiotics has contributed to our current state.

60Research funding and support for the description of resistance mechanisms, validation of current infection control practices, and antimicrobial development must be prioritized. Institutions supporting infection control, state of the art microbiology laboratories, and antimicrobial stewardship programs should receive recognition and incentives for their foresight. Despite these continuing challenges, considerable progress has been made to identify at-risk populations and to describe resistance determinants. Collaborative efforts have led to a better understanding and awareness of the epidemiology and the contribution of antimicrobial use and the environment to the propagation of antimicrobial resistance. These joint efforts have proven crucial for the propagation of information about carbapenemases. Continuing to encourage these partnerships is imperative in the ongoing struggle against antimicrobial resistance and to prevent antimicrobials from essentially becoming obsolete.

Conflict of Interest Statement

61The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References 275

1.
Abdelaziz M. O. Bonura C. Aleo A. El-Domany R. A. Fasciana T. Mammina C. (2012 ). OXA-163-producing Klebsiella pneumoniae in Cairo, Egypt, in 2009 and 2010. J. Clin. Microbiol. 50 2489–2491
Not in our library10.1128/jcm.06710-11
2.
Acosta J. Merino M. Viedma E. Poza M. Sanz F. Otero J. R. (2011 ). Multidrug-resistant Acinetobacter baumannii harboring OXA-24 carbapenemase, Spain. Emerg. Infect. Dis. 17 1064–1067
Not in our library10.3201/eid1706.091866
3.
Adams-Haduch J. M. Onuoha E. O. Bogdanovich T. Tian G. B. Marschall J. Urban C. M. (2011 ). Molecular epidemiology of carbapenem-nonsusceptible Acinetobacter baumannii in the United States. J. Clin. Microbiol. 49 3849–3854
Not in our library10.1128/jcm.00619-11
4.
Adler A. Shklyar M. Schwaber M. J. Navon-Venezia S. Dhaher Y. Edgar R. (2011 ). Introduction of OXA-48-producing Enterobacteriaceae to Israeli hospitals by medical tourism. J. Antimicrob. Chemother. 66 2763–2766
Not in our library10.1093/jac/dkr382
5.
Afzal-Shah M. Woodford N. Livermore D. M. (2001 ). Characterization of OXA-25, OXA-26, and OXA-27, molecular class D beta-lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii. Antimicrob. Agents Chemother. 45 583–588
Not in our library10.1128/aac.45.2.583-588.2001
6.
Aggen J. B. Armstrong E. S. Goldblum A. A. Dozzo P. Linsell M. S. Gliedt M. J. (2010 ). Synthesis and spectrum of the neoglycoside ACHN-490. Antimicrob. Agents Chemother. 54 4636–4642
Not in our library10.1128/aac.00572-10
7.
Ambler R. P. (1980 ). The structure of beta-lactamases. Philos. Trans. R. Soc. Lond. B Biol. Sci. 289 321–331
Not in our library10.1098/rstb.1980.0049
8.
Anthony K. B. Fishman N. O. Linkin D. R. Gasink L. B. Edelstein P. H. Lautenbach E. (2008 ). Clinical and microbiological outcomes of serious infections with multidrug-resistant Gram-negative organisms treated with tigecycline. Clin. Infect. Dis. 46 567–570
Not in our library10.1086/526775
9.
Antonio C. S. Neves P. R. Medeiros M. Mamizuka E. M. Elmor De Araujo M. R. Lincopan N. (2010 ). High prevalence of carbapenem-resistant Acinetobacter baumannii carrying the blaOXA-143 gene in Brazilian hospitals. Antimicrob. Agents Chemother. 55 1322–1323
Not in our library10.1128/aac.01102-10
10.
Arpin C. Noury P. Boraud D. Coulange L. Manetti A. Andre C. (2012 ). NDM-1-producing Klebsiella pneumoniae resistant to colistin in a French community patient without history of foreign travel. Antimicrob. Agents Chemother. 56 3432–3434
Not in our library10.1128/aac.00230-12
11.
Aschbacher R. Pagani L. Doumith M. Pike R. Woodford N. Spoladore, G., et al. (2010 ). Metallo-β-lactamases among Enterobacteriaceae from routine samples in an Italian tertiary-care hospital and long-term care facilities during 2008. Clin. Microbiol. Infect. 17 181–189
Not in our library10.1111/j.1198-743x.2010.03225.x
12.
Carbapenemase-producing Enterobacteriaceae , U.S. Rivers · 2005
No notice
13.
Bartual S. G. Seifert H. Hippler C. Luzon M. A. Wisplinghoff H. Rodriguez-Valera F. (2005 ). Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii. J. Clin. Microbiol. 43 4382–4390
Not in our library10.1128/jcm.43.9.4382-4390.2005
14.
Bassetti M. Ginocchio F. Mikulska M. (2011 ). New treatment options against Gram-negative organisms. Crit. Care 15 215
Not in our library10.1186/cc9997
15.
Ben-David D. M. D. Masarwa S. M. A. Navon-Venezia S. P. Mishali H. M. A. Fridental I. M. D. Rubinovitch B. M. D., et al. (2011 ). Carbapenem-resistant Klebsiella pneumoniae in post-acute-care facilities in Israel. Infect. Control Hosp. Epidemiol. 32 845–853
Not in our library10.1086/661279
16.
Bercot B. Poirel L. Dortet L. Nordmann P. (2011 ). In vitro evaluation of antibiotic synergy for NDM-1-producing Enterobacteriaceae. J. Antimicrob. Chemother. 66 2295–2297
Not in our library10.1093/jac/dkr296
17.
Bertini A. Poirel L. Bernabeu S. Fortini D. Villa L. Nordmann P. (2007 ). Multicopy blaOXA-58 gene as a source of high-level resistance to carbapenems in Acinetobacter baumannii. Antimicrob. Agents Chemother. 51 2324–2328
Not in our library10.1128/aac.01502-06
18.
Bilavsky E. Schwaber M. J. Carmeli Y. (2010 ). How to stem the tide of carbapenemase-producing Enterobacteriaceae?: proactive versus reactive strategies. Curr. Opin. Infect. Dis. 23 327–331
Not in our library10.1097/qco.0b013e32833b3571
19.
Biswas S. Brunel J.-M. Dubus J.-C. Reynaud-Gaubert M. Rolain J.-M. (2012 ). Colistin: an update on the antibiotic of the 21st century. Expert Rev. Anti Infect. Ther. 10 917–934
Not in our library10.1586/eri.12.78
20.
Bogaerts P. Naas T. El Garch F. Cuzon G. Deplano A. Delaire T. (2010 ). GES extended-spectrum beta-lactamases in Acinetobacter baumannii isolates in Belgium. Antimicrob. Agents Chemother. 54 4872–4878
Not in our library10.1128/aac.00871-10
21.
Bonnet R. Marchandin H. Chanal C. Sirot D. Labia R. De Champs C. (2002 ). Chromosome-encoded class D beta-lactamase OXA-23 in Proteus mirabilis. Antimicrob. Agents Chemother. 46 2004–2006
Not in our library10.1128/aac.46.6.2004-2006.2002
22.
Bonnin R. A. Nordmann P. Potron A. Lecuyer H. Zahar J. R. Poirel L. (2011 ). Carbapenem-hydrolyzing GES-type extended-spectrum beta-lactamase in Acinetobacter baumannii. Antimicrob. Agents Chemother. 55 349–354
Not in our library10.1128/aac.00773-10
23.
Bonnin R. A. Poirel L. Naas T. Pirs M. Seme K. Schrenzel J. (2012 ). Dissemination of New Delhi metallo-beta-lactamase-1-producing Acinetobacter baumannii in Europe. Clin. Microbiol. Infect. 18 E362–E365
Not in our library10.1111/j.1469-0691.2012.03928.x
24.
Bonnin R. A. Rotimi V. O. Al Hubail M. Gasiorowski E. Al Sweih N. Nordmann P. (2013 ). Wide dissemination of GES-type carbapenemases in Acinetobacter baumannii isolates in Kuwait. Antimicrob. Agents Chemother. 57 183–188
Not in our library10.1128/aac.01384-12
25.
Borgia S. Lastovetska O. Richardson D. Eshaghi A. Xiong J. Chung C. (2012 ). Outbreak of carbapenem-resistant Enterobacteriaceae containing blaNDM-1, Ontario, Canada. Clin. Infect. Dis. 55 e109–e117
Not in our library10.1093/cid/cis737
26.
Bou G. Cervero G. Dominguez M. A. Quereda C. Martinez-Beltran J. (2000a ). Characterization of a nosocomial outbreak caused by a multiresistant Acinetobacter baumannii strain with a carbapenem-hydrolyzing enzyme: high-level carbapenem resistance in A. baumannii is not due solely to the presence of beta-lactamases. J. Clin. Microbiol. 38 3299–3305
Not in our library10.1128/jcm.38.9.3299-3305.2000
27.
Bou G. Oliver A. Martinez-Beltran J. (2000b ). OXA-24, a novel class D beta-lactamase with carbapenemase activity in an Acinetobacter baumannii clinical strain. Antimicrob. Agents Chemother. 44 1556–1561
Not in our library10.1128/aac.44.6.1556-1561.2000
28.
Bratu S. Landman D. Alam M. Tolentino E. Quale J. (2005 ). Detection of KPC carbapenem-hydrolyzing enzymes in Enterobacter spp. from Brooklyn, New York. Antimicrob. Agents Chemother. 49 776–778
Not in our library10.1128/aac.49.2.776-778.2005
29.
Brown S. Young H. K Amyes S. G. B. (2005 ). Characterisation of OXA-51, a novel class D carbapenemase found in genetically unrelated clinical strains of Acinetobacter baumannii from Argentina. Clin. Microbiol. Infect. 11 15–23
Not in our library10.1111/j.1469-0691.2004.01016.x
30.
Bush K. Jacoby G. A. (2010 ). Updated functional classification of beta-lactamases. Antimicrob. Agents Chemother. 54 969–976
Not in our library10.1128/aac.01009-09
31.
Cai J. C. Zhou H. W. Zhang R. Chen G.-X. (2008 ). Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli isolates possessing the plasmid-mediated carbapenem-hydrolyzing beta-lactamase KPC-2 in intensive care units of a Chinese hospital. Antimicrob. Agents Chemother. 52 2014–2018
Not in our library10.1128/aac.01539-07
32.
Cai Y. Wang R. Liang B. Bai N. Liu Y. (2011 ). Systematic review and meta-analysis of the effectiveness and safety of tigecycline for treatment of infectious disease. Antimicrob. Agents Chemother. 55 1162–1172
Not in our library10.1128/aac.01402-10
33.
Canton R. Akova M. Carmeli Y. Giske C. G. Glupczynski Y. Gniadkowski M. (2012 ). Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. Clin. Microbiol. Infect. 18 413–431
Not in our library10.1111/j.1469-0691.2012.03821.x
34.
Carrer A. Poirel L. Pitout J. D. Church D. Nordmann P. (2008 ). Occurrence of an SME-2-producing Serratia marcescens isolate in Canada. Int. J. Antimicrob. Agents 31 181–182
Not in our library10.1016/j.ijantimicag.2007.10.007
35.
Carrer A. Poirel L. Yilmaz M. Akan O. A. Feriha C. Cuzon G. (2010 ). Spread of OXA-48-encoding plasmid in Turkey and Beyond. Antimicrob. Agents Chemother. 54 1369–1373
Not in our library10.1128/aac.01312-09
36.
Castanheira M. Deshpande L. M. Dipersio J. R. Kang J. Weinstein M. P. Jones R. N. (2009 ). First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY antimicrobial surveillance program. J. Clin. Microbiol. 47 4129–4130
Not in our library10.1128/jcm.01502-09
37.
Castanheira M. Deshpande L. M. Mathai D. Bell J. M. Jones R. N. Mendes R. E. (2011 ). Early dissemination of NDM-1- and OXA-181-producing Enterobacteriaceae in Indian hospitals: report from the SENTRY antimicrobial surveillance program, 2006–2007. Antimicrob. Agents Chemother. 55 1274–1278
Not in our library10.1128/aac.01497-10
38.
Castanheira M. Mendes R. E. Walsh T. R. Gales A. C. Jones R. N. (2004a ). Emergence of the extended-spectrum beta-lactamase GES-1 in a Pseudomonas aeruginosa strain from Brazil: report from the SENTRY antimicrobial surveillance program. Antimicrob. Agents Chemother. 48 2344–2345
Not in our library10.1128/aac.48.6.2344-2345.2004
39.
Castanheira M. Toleman M. A. Jones R. N. Schmidt F. J. Walsh T. R. (2004b ). Molecular characterization of a beta-lactamase gene, blaGIM-1, encoding a new subclass of metallo-beta-lactamase. Antimicrob. Agents Chemother. 48 4654–4661
Not in our library10.1128/aac.48.12.4654-4661.2004
40.
Castanheira M. Sader H. S. Deshpande L. M. Fritsche T. R. Jones R. N. (2008 ). Antimicrobial activities of tigecycline and other broad-spectrum antimicrobials tested against serine carbapenemase- and metallo-beta-lactamase-producing Enterobacteriaceae: report from the SENTRY antimicrobial surveillance program. Antimicrob. Agents Chemother. 52 570–573
Not in our library10.1128/aac.01114-07
41.
Centers for Disease Control and Prevention. (2009 ). Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. MMWR Morb. Mortal. Wkly. Rep. 58 256–260
Not in our library
42.
Chen P. Horton L. B. Mikulski R. L. Deng L. Sundriyal S. Palzkill T. (2012 ). 2-Substituted 4,5-dihydrothiazole-4-carboxylic acids are novel inhibitors of metallo-β-lactamases. Bioorg. Med. Chem. Lett. 22 6229–6232
Not in our library10.1016/j.bmcl.2012.08.012
43.
Coelho J. Woodford N. Afzal-Shah M. Livermore D. (2006 ). Occurrence of OXA-58-like carbapenemases in Acinetobacter spp. collected over 10 years in three continents. Antimicrob. Agents Chemother. 50 756–758
Not in our library10.1128/aac.50.2.756-758.2006
44.
Corvec S. Poirel L. Naas T. Drugeon H. Nordmann P. (2007 ). Genetics and expression of the carbapenem-hydrolyzing oxacillinase gene blaOXA-23 in Acinetobacter baumannii. Antimicrob. Agents Chemother. 51 1530–1533
Not in our library10.1128/aac.01132-06
45.
Crandon J. L. Schuck V. J. Banevicius M. A. Beaudoin M. E. Nichols W. W. Tanudra M. A. (2012 ). Comparative in vitro and in vivo efficacies of human simulated doses of ceftazidime and ceftazidime–avibactam against Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 56 6137–6146
Not in our library10.1128/aac.00851-12
46.
Culebras E. Gonzalez-Romo F. Head J. Gomez M. Morales G. Picazo J. J. (2010 ). Outbreak of Acinetobacter baumannii producing OXA-66 in a Spanish hospital: epidemiology and study of patient movements. Microb. Drug Resist. 16 309–315
Not in our library10.1089/mdr.2009.0113
47.
Worldwide Diversity of Klebsiella pneumoniae That Produce β-Lactamase bla KPC-2 Gene1 · 2010
No notice
48.
Cuzon G. Ouanich J. Gondret R. Naas T. Nordmann P. (2011 ). Outbreak of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in France. Antimicrob. Agents Chemother. 55 2420–2423
Not in our library10.1128/aac.01452-10
49.
da Fonseca é. L. Vieira V. V. Cipriano R Vicente A. C. P. (2007 ). Emergence of blaGES-5 in clinical colistin-only-sensitive (COS) Pseudomonas aeruginosa strain in Brazil. J. Antimicrob. Chemother. 59 576–577
Not in our library10.1093/jac/dkl517
50.
Darley E. Weeks J. Jones L. Daniels V. Wootton M. Macgowan A. (2012 ). NDM-1 polymicrobial infections including Vibrio cholerae. Lancet 380 1358
Not in our library10.1016/s0140-6736(12)60911-8
51.
Da Silva G. J. Quinteira S. Bértolo E. Sousa J. C. Gallego L. Duarte A. (2004 ). Long-term dissemination of an OXA-40 carbapenemase-producing Acinetobacter baumannii clone in the Iberian Peninsula. J. Antimicrob. Chemother. 54 255–258
Not in our library10.1093/jac/dkh269
52.
Decre D. Birgand G. Geneste D. Maury E. Petit J. C. Barbut F. (2010 ). Possible importation and subsequent cross-transmission of OXA-48-producing Klebsiella pneumoniae, France, 2010. Euro Surveill. 15, pii 19718
Not in our library10.2807/ese.15.46.19718-en
53.
Deris Z. Z. Yu H. H. Davis K. Soon R. L. Jacob J. Ku C. K. (2012 ). The combination of colistin and doripenem is synergistic against Klebsiella pneumoniae at multiple inocula and suppresses colistin resistance in an in vitro pharmacokinetic/pharmacodynamic model. Antimicrob. Agents Chemother. 56 5103–5112
Not in our library10.1128/aac.01064-12
54.
Deshpande L. M. Jones R. N. Fritsche T. R. Sader H. S. (2006a ). Occurrence and characterization of carbapenemase-producing Enterobacteriaceae: report from the SENTRY antimicrobial surveillance program (2000–2004). Microb. Drug Resist. 12 223–230
Not in our library10.1089/mdr.2006.12.223
55.
Deshpande L. M. Rhomberg P. R. Sader H. S. Jones R. N. (2006b ). Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999–2005). Diagn. Microbiol. Infect. Dis. 56 367–372
Not in our library10.1016/j.diagmicrobio.2006.07.004
56.
The Population Structure of Acinetobacter baumannii: Expanding Multiresistant Clones from an Ancestral Susceptible Genetic Pool · 2010
No notice
57.
Di Popolo A. Giannouli M. Triassi M. Brisse S. Zarrilli R. (2011 ). Molecular epidemiological investigation of multidrug-resistant Acinetobacter baumannii strains in four Mediterranean countries with a multilocus sequence typing scheme. Clin. Microbiol. Infect. 17 197–201
Not in our library10.1111/j.1469-0691.2010.03254.x
58.
Docquier J.-D. Calderone V. De Luca F. Benvenuti M. Giuliani F. Bellucci L. (2009 ). Crystal structure of the OXA-48 β-lactamase reveals mechanistic diversity among class D carbapenemases. Chem. Biol. 16 540–547
Not in our library10.1016/j.chembiol.2009.04.010
59.
Dortet L. Nordmann P. Poirel L. (2012 ). Association of the emerging carbapenemase NDM-1 with a bleomycin resistance protein in Enterobacteriaceae and Acinetobacter baumannii. Antimicrob. Agents Chemother. 56 1693–1697
Not in our library10.1128/aac.05583-11
60.
El-Gamal M. I. Oh C. H. (2010 ). Current status of carbapenem antibiotics. Curr. Top. Med. Chem. 10 1882–1897
Not in our library10.2174/156802610793176639
61.
El Salabi A. Borra P. S. Toleman M. A. Samuelsen O. Walsh T. R. (2012 ). Genetic and biochemical characterization of a novel metallo-beta-lactamase, TMB-1, from an Achromobacter xylosoxidans strain isolated in Tripoli, Libya. Antimicrob. Agents Chemother. 56 2241–2245
Not in our library10.1128/aac.05640-11
62.
Endimiani A. Bethel C. Choudhary Y. Bonomo R. A. (2010a ). In vitro activity of penem-1 in combination with beta-lactams against blaKPC-possessing Klebsiella pneumoniae isolates. Antimicrob. Agents Chemother. 54 1650–1651
Not in our library10.1128/aac.01821-09
63.
Endimiani A. Patel G. Hujer K. M. Swaminathan M. Perez F. Rice L. B. (2010b ). In vitro activity of fosfomycin against blaKPC-containing Klebsiella pneumoniae isolates, including those nonsusceptible to tigecycline and/or colistin. Antimicrob. Agents Chemother. 54 526–529
Not in our library10.1128/aac.01235-09
64.
Endimiani A. Carias L. L. Hujer A. M. Bethel C. R. Hujer K. M. Perez F. (2008 ). Presence of plasmid-mediated quinolone resistance in Klebsiella pneumoniae isolates possessing blaKPC in the United States. Antimicrob. Agents Chemother. 52 2680–2682
Not in our library10.1128/aac.00158-08
65.
Endimiani A. Choudhary Y. Bonomo R. A. (2009a ). In vitro activity of NXL104 in combination with beta-lactams against Klebsiella pneumoniae isolates producing KPC carbapenemases. Antimicrob. Agents Chemother. 53 3599–3601
Not in our library10.1128/aac.00641-09
66.
Endimiani A. Hujer A. M. Perez F. Bethel C. R. Hujer K. M. Kroeger J. (2009b ). Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA. J. Antimicrob. Chemother. 63 427–437
Not in our library10.1093/jac/dkn547
67.
Endimiani A. Hujer K. M. Hujer A. M. Armstrong E. S. Choudhary Y. Aggen J. B. (2009c ). ACHN-490, a neoglycoside with potent in vitro activity against multidrug-resistant Klebsiella pneumoniae isolates. Antimicrob. Agents Chemother. 53 4504–4507
Not in our library10.1128/aac.00556-09
68.
Endimiani A. Paterson D. L. (2007 ). Optimizing therapy for infections caused by enterobacteriaceae producing extended-spectrum beta-lactamases. Semin. Respir. Crit. Care Med. 28 646–655
Not in our library10.1055/s-2007-996411
69.
Evans B. A. Brown S. Hamouda A. Findlay J Amyes S. G. B. (2007 ). Eleven novel OXA-51-like enzymes from clinical isolates of Acinetobacter baumannii. Clin. Microbiol. Infect. 13 1137–1138
Not in our library10.1111/j.1469-0691.2007.01828.x
70.
Fairfax M. R. Queenan A. M. Lephart P. R. Kaye K. S. Dror M. Arnous N. (2011 ). Detection of 2 SME-1 carbapenemase-producing Serratia marcescens in Detroit. Diagn. Microbiol. Infect. Dis. 71 325–326
Not in our library10.1016/j.diagmicrobio.2011.06.007
71.
Falagas M. E. Kanellopoulou M. D. Karageorgopoulos D. E. Dimopoulos G. Rafailidis P. I. Skarmoutsou N. D. (2008 ). Antimicrobial susceptibility of multidrug-resistant Gram negative bacteria to fosfomycin. Eur. J. Clin. Microbiol. Infect. Dis. 27 439–443
Not in our library10.1007/s10096-007-0456-4
72.
Falagas M. E. Karageorgopoulos D. E. Nordmann P. (2011 ). Therapeutic options for infections with Enterobacteriaceae producing carbapenem-hydrolyzing enzymes. Future Microbiol. 6 653–666
Not in our library10.2217/fmb.11.49
73.
Falagas M. E. Kasiakou S. K. (2005 ). Colistin: the revival of polymyxins for the management of multidrug-resistant Gram-negative bacterial infections. Clin. Infect. Dis. 40 1333–1341
Not in our library10.1086/429323
74.
Falagas M. E. Kastoris A. C. Karageorgopoulos D. E. Rafailidis P. I. (2009 ). Fosfomycin for the treatment of infections caused by multidrug-resistant non-fermenting Gram-negative bacilli: a systematic review of microbiological, animal and clinical studies. Int. J. Antimicrob. Agents 34 111–120
Not in our library10.1016/j.ijantimicag.2009.03.009
75.
Figueiredo S. Poirel L. Croize J. Recule C. Nordmann P. (2009 ). In vivo selection of reduced susceptibility to carbapenems in Acinetobacter baumannii related to ISAba1-mediated overexpression of the natural blaOXA-66 oxacillinase gene. Antimicrob. Agents Chemother. 53 2657–2659
Not in our library10.1128/aac.01663-08
76.
Fritsche T. R. Strabala P. A. Sader H. S. Dowzicky M. J. Jones R. N. (2005 ). Activity of tigecycline tested against a global collection of Enterobacteriaceae, including tetracycline-resistant isolates. Diagn. Microbiol. Infect. Dis. 52 209–213
Not in our library10.1016/j.diagmicrobio.2005.06.010
77.
Gales A. C. Castanheira M. Jones R. N. Sader H. S. (2012 ). Antimicrobial resistance among Gram-negative bacilli isolated from Latin America: results from SENTRY Antimicrobial Surveillance Program (Latin America, 2008–2010). Diagn. Microbiol. Infect. Dis. 73 354–360
Not in our library10.1016/j.diagmicrobio.2012.04.007
78.
Geffen Y. Adler A. Paikin S. Khabra E. Gorenshtein S. Aronov R. (2012 ). Detection of the plasmid-mediated KPC-2 carbapenem-hydrolysing enzyme in three unusual species of the Enterobacteriaceae family in Israel. J. Antimicrob. Chemother. 68 719–720
Not in our library10.1093/jac/dks443
79.
Ghazawi A. Sonnevend A. Bonnin R. A. Poirel L. Nordmann P. Hashmey R. (2012 ). NDM-2 carbapenemase-producing Acinetobacter baumannii in the United Arab Emirates. Clin. Microbiol. Infect. 18 E34–E36
Not in our library10.1111/j.1469-0691.2011.03726.x
80.
Giakkoupi P. Papagiannitsis C. C. Miriagou V. Pappa O. Polemis M. Tryfinopoulou K. (2011 ). An update of the evolving epidemic of blaKPC-2-carrying Klebsiella pneumoniae in Greece (2009–10). J. Antimicrob. Chemother. 66 1510–1513
Not in our library10.1093/jac/dkr166
81.
Giakkoupi P. Xanthaki A. Kanelopoulou M. Vlahaki A. Miriagou V. Kontou S. (2003 ). VIM-1 metallo-beta-lactamase-producing Klebsiella pneumoniae strains in Greek hospitals. J. Clin. Microbiol. 41 3893–3896
Not in our library10.1128/jcm.41.8.3893-3896.2003
82.
Giani T. Conte V. Di Pilato V. Aschbacher R. Weber C. Larcher C. (2012 ). Escherichia coli from Italy producing OXA-48 carbapenemase encoded by a novel Tn1999 transposon derivative. Antimicrob. Agents Chemother. 56 2211–2213
Not in our library10.1128/aac.00035-12
83.
Girlich D. Poirel L. Nordmann P. (2010 ). Novel ambler class A carbapenem-hydrolyzing beta-lactamase from a Pseudomonas fluorescens isolate from the Seine River, Paris, France. Antimicrob. Agents Chemother. 54 328–332
Not in our library10.1128/aac.00961-09
84.
Gogou V. Pournaras S. Giannouli M. Voulgari E. Piperaki E.-T. Zarrilli R. (2011 ). Evolution of multidrug-resistant Acinetobacter baumannii clonal lineages: a 10 year study in Greece (2000–09). J. Antimicrob. Chemother. 66 2767–2772
Not in our library10.1093/jac/dkr390
85.
Gregory C. J. Llata E. Stine N. Gould C. Santiago L. M. Vazquez G. J. (2010 ). Outbreak of carbapenem-resistant Klebsiella pneumoniae in Puerto Rico associated with a novel carbapenemase variant. Infect. Control Hosp. Epidemiol. 31 476–484
Not in our library10.1086/651670
86.
Grosso F. Quinteira S. Peixe L. (2011 ). Understanding the dynamics of imipenem-resistant Acinetobacter baumannii lineages within Portugal. Clin. Microbiol. Infect. 17 1275–1279
Not in our library10.1111/j.1469-0691.2011.03469.x
87.
Gülmez D. Woodford N. Palepou M.-F. I. Mushtaq S. Metan G. Yakupogullari Y. (2008 ). Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae isolates from Turkey with OXA-48-like carbapenemases and outer membrane protein loss. Int. J. Antimicrob. Agents 31 523–526
Not in our library10.1016/j.ijantimicag.2008.01.017
88.
Gupta N. Limbago B. M. Patel J. B. Kallen A. J. (2011 ). Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin. Infect. Dis. 53 60–67
Not in our library10.1093/cid/cir202
89.
Halaby T. Reuland A. E. Al Naiemi N. Potron A. Savelkoul P. H. Vandenbroucke-Grauls C. M. (2012 ). A case of New Delhi metallo-beta-lactamase 1 (NDM-1)-producing Klebsiella pneumoniae with putative secondary transmission from the Balkan region in the Netherlands. Antimicrob. Agents Chemother. 56 2790–2791
Not in our library10.1128/aac.00111-12
90.
Hays C. Benouda A. Poirel L. Elouennass M. Nordmann P. (2012 ). Nosocomial occurrence of OXA-48-producing enterobacterial isolates in a Moroccan hospital. Int. J. Antimicrob. Agents 39 545–547
Not in our library10.1016/j.ijantimicag.2012.03.002
91.
Henriques I. Moura A. Alves A. Saavedra M. J. Correia A. (2004 ). Molecular characterization of a carbapenem-hydrolyzing class A beta-lactamase, SFC-1, from Serratia fonticola UTAD54. Antimicrob. Agents Chemother. 48 2321–2324
Not in our library10.1128/aac.48.6.2321-2324.2004
92.
Héritier C. Dubouix A. Poirel L. Marty N. Nordmann P. (2005a ). A nosocomial outbreak of Acinetobacter baumannii isolates expressing the carbapenem-hydrolysing oxacillinase OXA-58. J. Antimicrob. Chemother. 55 115–118
Not in our library10.1093/jac/dkh500
93.
Héritier C. Poirel L. Fournier P.-E. Claverie J.-M. Raoult D. Nordmann P. (2005b ). Characterization of the naturally occurring oxacillinase of Acinetobacter baumannii. Antimicrob. Agents Chemother. 49 4174–4179
Not in our library10.1128/aac.49.10.4174-4179.2005
94.
Héritier C. Poirel L. Nordmann P. (2004 ). Genetic and biochemical characterization of a chromosome-encoded carbapenem-hydrolyzing ambler class D β-lactamase from Shewanella algae. Antimicrob. Agents Chemother. 48 1670–1675
Not in our library10.1128/aac.48.5.1670-1675.2004
95.
Higgins P. G. Janssen K. Fresen M. M. Wisplinghoff H. Seifert H. (2012a ). Molecular epidemiology of Acinetobacter baumannii bloodstream isolates obtained in the United States from 1995 to 2004 using rep-PCR and multilocus sequence typing. J. Clin. Microbiol. 50 3493–3500
Not in our library10.1128/jcm.01759-12
96.
Higgins P. G. Stefanik D. Page M. G. P. Hackel M. Seifert H. (2012b ). In vitro activity of the siderophore monosulfactam BAL30072 against meropenem-non-susceptible Acinetobacter baumannii. J. Antimicrob. Chemother. 67 1167–1169
Not in our library10.1093/jac/dks009
97.
Higgins P. G. Poirel L. Lehmann M. Nordmann P. Seifert H. (2009 ). OXA-143, a novel carbapenem-hydrolyzing class D beta-lactamase in Acinetobacter baumannii. Antimicrob. Agents Chemother. 53 5035–5038
Not in our library10.1128/aac.00856-09
98.
Hirsch E. B. Ledesma K. R. Chang K. T. Schwartz M. S. Motyl M. R. Tam V. H. (2012 ). In vitro activity of MK-7655, a novel beta-lactamase inhibitor, in combination with imipenem against carbapenem-resistant Gram-negative bacteria. Antimicrob. Agents Chemother. 56 3753–3757
Not in our library10.1128/aac.05927-11
99.
Hirsch E. B. Tam V. H. (2010 ). Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J. Antimicrob. Chemother. 65 1119–1125
Not in our library10.1093/jac/dkq108
100.
Hujer K. M. Hujer A. M. Hulten E. A. Bajaksouzian S. Adams J. M. Donskey C. J. (2006 ). Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center. Antimicrob. Agents Chemother. 50 4114–4123
Not in our library10.1128/aac.00778-06
101.
Ishii Y. Eto M. Mano Y. Tateda K. Yamaguchi K. (2010 ). In vitro potentiation of carbapenems with ME1071, a novel metallo-beta-lactamase inhibitor, against metallo-beta-lactamase-producing Pseudomonas aeruginosa clinical isolates. Antimicrob. Agents Chemother. 54 3625–3629
Not in our library10.1128/aac.01397-09
102.
Ito H. Arakawa Y. Ohsuka S. Wacharotayankun R. Kato N. Ohta M. (1995 ). Plasmid-mediated dissemination of the metallo-beta-lactamase gene blaIMP among clinically isolated strains of Serratia marcescens. Antimicrob. Agents Chemother. 39 824–829
Not in our library10.1128/aac.39.4.824
103.
Jeong S. H. Bae I. K. Kim D. Hong S. G. Song J. S. Lee J. H. (2005 ). First outbreak of Klebsiella pneumoniae clinical isolates producing GES-5 and SHV-12 extended-spectrum beta-lactamases in Korea. Antimicrob. Agents Chemother. 49 4809–4810
Not in our library10.1128/aac.49.11.4809-4810.2005
104.
Jernigan M. G. Press E. G. Nguyen M. H. Clancy C. J. Shields R. K. (2012 ). The combination of doripenem and colistin is bactericidal and synergistic against colistin-resistant, carbapenemase-producing Klebsiella pneumoniae. Antimicrob. Agents Chemother. 56 3395–3398
Not in our library10.1128/aac.06364-11
105.
Jovcic B. Lepsanovic Z. Suljagic V. Rackov G. Begovic J. Topisirovic L. (2011 ). Emergence of NDM-1 metallo-beta-lactamase in Pseudomonas aeruginosa clinical isolates from Serbia. Antimicrob. Agents Chemother. 55 3929–3931
Not in our library10.1128/aac.00226-11
106.
Kaase M. Nordmann P. Wichelhaus T. A. Gatermann S. G. Bonnin R. A. Poirel L. (2011 ). NDM-2 carbapenemase in Acinetobacter baumannii from Egypt. J. Antimicrob. Chemother. 66 1260–1262
Not in our library10.1093/jac/dkr135
107.
Karageorgopoulos D. E. Wang R. Yu X.-H. Falagas M. E. (2012 ). Fosfomycin: evaluation of the published evidence on the emergence of antimicrobial resistance in Gram-negative pathogens. J. Antimicrob. Chemother. 67 255–268
Not in our library10.1093/jac/dkr466
108.
Kassis-Chikhani N. Decre D. Gautier V. Burghoffer B. Saliba F. Mathieu D. (2006 ). First outbreak of multidrug-resistant Klebsiella pneumoniae carrying blaVIM-1 and blaSHV-5 in a French university hospital. J. Antimicrob. Chemother. 57 142–145
Not in our library10.1093/jac/dki389
109.
King D. T. Worrall L. J. Gruninger R. Strynadka N. C. (2012 ). New Delhi metallo-beta-lactamase: structural insights into beta-lactam recognition and inhibition. J. Am. Chem. Soc. 134 11362–11365
Not in our library10.1021/ja303579d
110.
Kitchel B. Rasheed J. K. Endimiani A. Hujer A. M. Anderson K. F. Bonomo R. A. (2010 ). Genetic factors associated with elevated carbapenem resistance in KPC-producing Klebsiella pneumoniae. Antimicrob. Agents Chemother. 54 4201–4207
Not in our library10.1128/aac.00008-10
111.
Kitchel B. Rasheed J. K. Patel J. B. Srinivasan A. Navon-Venezia S. Carmeli Y. (2009a ). Molecular epidemiology of KPC-producing Klebsiella pneumoniae isolates in the United States: clonal expansion of multilocus sequence type 258. Antimicrob. Agents Chemother. 53 3365–3370
Not in our library10.1128/aac.00126-09
112.
Kitchel B. Sundin D. R. Patel J. B. (2009b ). Regional dissemination of KPC-producing Klebsiella pneumoniae. Antimicrob. Agents Chemother. 53 4511–4513
Not in our library10.1128/aac.00784-09
113.
Kotsakis S. D. Miriagou V. Tzelepi E. Tzouvelekis L. S. (2010 ). Comparative biochemical and computational study of the role of naturally occurring mutations at Ambler positions 104 and 170 in GES beta-lactamases. Antimicrob. Agents Chemother. 54 4864–4871
Not in our library10.1128/aac.00771-10
114.
Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study · 2010
No notice
115.
Kus J. V. Tadros M. Simor A. Low D. E. Mcgeer A. J. Willey B. M. (2011 ). New Delhi metallo-beta-lactamase-1: local acquisition in Ontario, Canada, and challenges in detection. CMAJ 183 1257–1261
Not in our library10.1503/cmaj.110477
116.
Landman D. Georgescu C. Martin D.A. Quale J. (2008 ). Polymyxins revisited. Clin. Microbiol. Rev. 21 449–465
Not in our library10.1128/cmr.00006-08
117.
Landman D. Kelly P. Bäcker M. Babu E. Shah N. Bratu S. (2011 ). Antimicrobial activity of a novel aminoglycoside, ACHN-490, against Acinetobacter baumannii and Pseudomonas aeruginosa from New York City. J. Antimicrob. Chemother. 66 332–334
Not in our library10.1093/jac/dkq459
118.
Lascols C. Hackel M. Marshall S. H. Hujer A. M. Bouchillon S. Badal R. (2011 ). Increasing prevalence and dissemination of NDM-1 metallo-β-lactamase in India: data from the SMART study (2009). J. Antimicrob. Chemother. 66 1992–1997
Not in our library10.1093/jac/dkr240
119.
Lascols C. Peirano G. Hackel M. Laupland K. B. Pitout J. D. (2012 ). Surveillance and molecular epidemiology of Klebsiella pneumoniae that produce carbapenemases; the first report of OXA-48-like enzymes in North America. Antimicrob Agents Chemother. 57 130–136
Not in our library10.1128/aac.01686-12
120.
Lauretti L. Riccio M. L. Mazzariol A. Cornaglia G. Amicosante G. Fontana R. (1999 ). Cloning and characterization of blaVIM, a new integron-borne metallo-beta-lactamase gene from a Pseudomonas aeruginosa clinical isolate. Antimicrob. Agents Chemother. 43 1584–1590
Not in our library10.1128/aac.43.7.1584
121.
Lautenbach E. Synnestvedt M. Weiner M. G. Bilker W. B. Vo L. Schein J. (2009 ). Epidemiology and impact of imipenem resistance in Acinetobacter baumannii. Infect. Control Hosp. Epidemiol. 30 1186–1192
Not in our library10.1086/648450
122.
Lautenbach E. Synnestvedt M. Weiner M. G. Bilker W. B. Vo L. Schein J. (2010 ). Imipenem resistance in Pseudomonas aeruginosa: emergence, epidemiology, and impact on clinical and economic outcomes. Infect. Control Hosp. Epidemiol. 31 47–53
Not in our library10.1086/649021
123.
Lee J. Patel G. Huprikar S. Calfee D. P. Jenkins S. G. (2009 ). Decreased susceptibility to polymyxin B during treatment for carbapenem-resistant Klebsiella pneumoniae infection. J. Clin. Microbiol. 47 1611–1612
Not in our library10.1128/jcm.02466-08
124.
Lee K. Yum J. H. Yong D. Lee H. M. Kim H. D. Docquier J.-D. (2005 ). Novel acquired metallo-beta-lactamase gene, blaSIM-1, in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea. Antimicrob. Agents Chemother. 49 4485–4491
Not in our library10.1128/aac.49.11.4485-4491.2005
125.
Levasseur P. Girard A. M. Claudon M. Goossens H. Black M. T. Coleman K. (2012 ). In vitro antibacterial activity of the ceftazidime–avibactam (NXL104) combination against Pseudomonas aeruginosa clinical isolates. Antimicrob. Agents Chemother. 56 1606–1608
Not in our library10.1128/aac.06064-11
126.
Li J. Nation R. L. Turnidge J. D. Milne R. W. Coulthard K. Rayner C. R. (2006a ). Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect. Dis. 6 589–601
Not in our library10.1016/s1473-3099(06)70580-1
127.
Li J. Rayner C. R. Nation R. L. Owen R. J. Spelman D. Tan K. E. (2006b ). Heteroresistance to colistin in multidrug-resistant Acinetobacter baumannii. Antimicrob. Agents Chemother. 50 2946–2950
Not in our library10.1128/aac.00103-06
128.
Livermore D. M. Mushtaq S. Morinaka A. Ida T. Maebashi K. Hope R. (2013 ). Activity of carbapenems with ME1071 (disodium 2,3-diethylmaleate) against Enterobacteriaceae and Acinetobacter spp. with carbapenemases, including NDM enzymes. J. Antimicrob. Chemother. 68 153–158
Not in our library10.1093/jac/dks350
129.
Livermore D. M. Mushtaq S. Warner M. (2010 ). Activity of BAL30376 (monobactam BAL19764 + BAL29880 + clavulanate) versus Gram-negative bacteria with characterized resistance mechanisms. J. Antimicrob. Chemother. 65 2382–2395
Not in our library10.1093/jac/dkq310
130.
Livermore D. M. Mushtaq S. Warner M. Miossec C. Woodford N. (2008 ). NXL104 combinations versus Enterobacteriaceae with CTX-M extended-spectrum beta-lactamases and carbapenemases. J. Antimicrob. Chemother. 62 1053–1056
Not in our library10.1093/jac/dkn320
131.
Livermore D. M. Mushtaq S. Warner M. Zhang J.-C. Maharjan S. Doumith M. (2011a ). Activity of aminoglycosides, including ACHN-490, against carbapenem-resistant Enterobacteriaceae isolates. J. Antimicrob. Chemother. 66 48–53
Not in our library10.1093/jac/dkq408
132.
Livermore D. M. Mushtaq S. Warner M. Zhang J. Maharjan S. Doumith M. (2011b ). Activities of NXL104 combinations with ceftazidime and aztreonam against carbapenemase-producing Enterobacteriaceae. Antimicrob. Agents Chemother. 55 390–394
Not in our library10.1128/aac.00756-10
133.
Livermore D. M. Walsh T. R. Toleman M. Woodford N. (2011c ). Balkan NDM-1: escape or transplant? Lancet Infect. Dis. 11 164
Not in our library10.1016/s1473-3099(11)70048-2
134.
Livermore D. M. Warner M. Mushtaq S. Doumith M. Zhang J. Woodford N. (2011d ). What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline. Int. J. Antimicrob. Agents 37 415–419
Not in our library10.1016/j.ijantimicag.2011.01.012
135.
Lolans K. Rice T. W. Munoz-Price L. S. Quinn J. P. (2006 ). Multicity outbreak of carbapenem-resistant Acinetobacter baumannii isolates producing the carbapenemase OXA-40. Antimicrob. Agents Chemother. 50 2941–2945
Not in our library10.1128/aac.00116-06
136.
Lopez-Otsoa F. Gallego L. Towner K. J. Tysall L. Woodford N. Livermore D. M. (2002 ). Endemic carbapenem resistance associated with OXA-40 carbapenemase among Acinetobacter baumannii isolates from a hospital in Northern Spain. J. Clin. Microbiol. 40 4741–4743
Not in our library10.1128/jcm.40.12.4741-4743.2002
137.
Marchaim D. Chopra T. Bhargava A. Bogan C. Dhar S. Hayakawa K. (2012 ). Recent exposure to antimicrobials and carbapenem-resistant Enterobacteriaceae: the role of antimicrobial stewardship. Infect. Control Hosp. Epidemiol. 33 817–830
Not in our library10.1086/666642
138.
Marchaim D. Chopra T. Perez F. Hayakawa K. Lephart P. R. Bheemreddy S. (2011 ). Outcomes and genetic relatedness of carbapenem-resistant enterobacteriaceae at Detroit medical center. Infect. Control Hosp. Epidemiol. 32 861–871
Not in our library10.1086/661597
139.
Mataseje L. F. Bryce E. Roscoe D. Boyd D. A. Embree J. Gravel D. (2012 ). Carbapenem-resistant Gram-negative bacilli in Canada 2009–10: results from the Canadian Nosocomial Infection Surveillance Program (CNISP). J. Antimicrob. Chemother. 67 1359–1367
Not in our library10.1093/jac/dks046
140.
Mathers A. J. Cox H. L. Kitchel B. Bonatti H. Brassinga A. K. Carroll J. (2011 ). Molecular dissection of an outbreak of carbapenem-resistant enterobacteriaceae reveals intergenus KPC carbapenemase transmission through a promiscuous plasmid. MBio 2 e00204–e00211
Not in our library10.1128/mbio.00204-11
141.
Mathers A. J. Hazen K. C. Carroll J. Yeh A. J. Cox H. L. Bonomo R. A. (2012 ). First clinical cases of OXA-48 producing carbapenem resistant Klebsiella pneumoniae in the United States: the “menace” arrives in the New World. J. Clin. Microbiol. 51 680–683
Not in our library10.1128/jcm.02580-12
142.
Meletis G. Tzampaz E. Sianou E. Tzavaras I. Sofianou D. (2011 ). Colistin heteroresistance in carbapenemase-producing Klebsiella pneumoniae. J. Antimicrob. Chemother. 66 946–947
Not in our library10.1093/jac/dkr007
143.
Mendes R. E. Bell J. M. Turnidge J. D. Castanheira M. Jones R. N. (2009 ). Emergence and widespread dissemination of OXA-23, -24/40 and -58 carbapenemases among Acinetobacter spp. in Asia-Pacific nations: report from the SENTRY Surveillance Program. J. Antimicrob. Chemother. 63 55–59
Not in our library10.1093/jac/dkn434
144.
Michalopoulos A. Virtzili S. Rafailidis P. Chalevelakis G. Damala M. Falagas M. E. (2010 ). Intravenous fosfomycin for the treatment of nosocomial infections caused by carbapenem-resistant Klebsiella pneumoniae in critically ill patients: a prospective evaluation. Clin. Microbiol. Infect. 16 184–186
Not in our library10.1111/j.1469-0691.2009.02921.x
145.
Miriagou V. Tzouvelekis L. S. Rossiter S. Tzelepi E. Angulo F. J. Whichard J. M. (2003 ). Imipenem resistance in a Salmonella clinical strain due to plasmid-mediated class A carbapenemase KPC-2. Antimicrob. Agents Chemother. 47 1297–1300
Not in our library10.1128/aac.47.4.1297-1300.2003
146.
Morfin-Otero R. Rodriguez-Noriega E. Deshpande L. M. Sader H. S. Castanheira M. (2009 ). Dissemination of a bla(VIM-2)-carrying integron among Enterobacteriaceae species in Mexico: report from the SENTRY Antimicrobial Surveillance Program. Microb. Drug Resist. 15 33–35
Not in our library10.1089/mdr.2009.0878
147.
Mostachio A. K. Levin A. S. Rizek C. Rossi F. Zerbini J. Costa S. F. (2012 ). High prevalence of OXA-143 and alteration of outer membrane proteins in carbapenem-resistant Acinetobacter spp. isolates in Brazil. Int. J. Antimicrob. Agents 39 396–401
Not in our library10.1016/j.ijantimicag.2012.01.021
148.
Moubareck C. Bremont S. Conroy M. C. Courvalin P. Lambert T. (2009 ). GES-11, a novel integron-associated GES variant in Acinetobacter baumannii. Antimicrob. Agents Chemother. 53 3579–3581
Not in our library10.1128/aac.00072-09
149.
Worldwide Dissemination of the bla OXA-23 Carbapenemase Gene of Acinetobacter baumannii 1 · 2009
No notice
150.
Mushtaq S. Irfan S. Sarma J. B. Doumith M. Pike R. Pitout J. (2011 ). Phylogenetic diversity of Escherichia coli strains producing NDM-type carbapenemases. J. Antimicrob. Chemother. 66 2002–2005
Not in our library10.1093/jac/dkr226
151.
Mushtaq S. Warner M. Livermore D. (2010a ). Activity of the siderophore monobactam BAL30072 against multiresistant non-fermenters. J. Antimicrob. Chemother. 65 266–270
Not in our library10.1093/jac/dkp425
152.
Mushtaq S. Warner M. Livermore D. M. (2010b ). In vitro activity of ceftazidime + NXL104 against Pseudomonas aeruginosa and other non-fermenters. J. Antimicrob. Chemother. 65 2376–2381
Not in our library10.1093/jac/dkq306
153.
Mushtaq S. Warner M. Williams G. Critchley I. Livermore D. M. (2010c ). Activity of chequerboard combinations of ceftaroline and NXL104 versus β-lactamase-producing Enterobacteriaceae. J. Antimicrob. Chemother. 65 1428–1432
Not in our library10.1093/jac/dkq161
154.
Naas T. Cuzon G. Villegas M.-V. Lartigue M.-F. Quinn J. P. Nordmann P. (2008 ). Genetic structures at the origin of acquisition of the beta-lactamase blaKPC gene. Antimicrob. Agents Chemother. 52 1257–1263
Not in our library10.1128/aac.01451-07
155.
Naas T. Vandel L. Sougakoff W. Livermore D. M. Nordmann P. (1994 ). Cloning and sequence analysis of the gene for a carbapenem-hydrolyzing class A beta-lactamase, Sme-1, from Serratia marcescens S6. Antimicrob. Agents Chemother. 38 1262–1270
Not in our library10.1128/aac.38.6.1262
156.
Navon-Venezia S. Leavitt A. Carmeli Y. (2007 ). High tigecycline resistance in multidrug-resistant Acinetobacter baumannii. J. Antimicrob. Chemother. 59 772–774
Not in our library10.1093/jac/dkm018
157.
Navon-Venezia S. Leavitt A. Schwaber M. J. Rasheed J. K. Srinivasan A. Patel J. B. (2009 ). First report on a hyperepidemic clone of KPC-3-producing Klebsiella pneumoniae in Israel genetically related to a strain causing outbreaks in the United States. Antimicrob. Agents Chemother. 53 818–820
Not in our library10.1128/aac.00987-08
158.
Nordmann P. Boulanger A. E. Poirel L. (2012a ). NDM-4 metallo-beta-lactamase with increased carbapenemase activity from Escherichia coli. Antimicrob. Agents Chemother. 56 2184–2186
Not in our library10.1128/aac.05961-11
159.
Nordmann P. Couard J.-P. Sansot D. Poirel L. (2012b ). Emergence of an autochthonous and community-acquired NDM-1–producing Klebsiella pneumoniae in Europe. Clin. Infect. Dis. 54 150–151
Not in our library10.1093/cid/cir720
160.
Nordmann P. Gniadkowski M. Giske C. G. Poirel L. Woodford N. Miriagou V. (2012c ). Identification and screening of carbapenemase-producing Enterobacteriaceae. Clin. Microbiol. Infect. 18 432–438
Not in our library10.1111/j.1469-0691.2012.03815.x
161.
Nordmann P. Cuzon G. Naas T. (2009 ). The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect. Dis. 9 228–236
Not in our library10.1016/s1473-3099(09)70054-4
162.
Nordmann P. Mariotte S. Naas T. Labia R. Nicolas M. H. (1993 ). Biochemical properties of a carbapenem-hydrolyzing beta-lactamase from Enterobacter cloacae and cloning of the gene into Escherichia coli. Antimicrob. Agents Chemother. 37 939–946
Not in our library10.1128/aac.37.5.939
163.
Nordmann P. Poirel L. Walsh T. R. Livermore D. M. (2011 ). The emerging NDM carbapenemases. Trends Microbiol. 19 588–595
Not in our library10.1016/j.tim.2011.09.005
164.
Noskin G. A. (2005 ). Tigecycline: a new glycylcycline for treatment of serious infections. Clin. Infect. Dis. 41 S303–S314
Not in our library10.1086/431672
165.
Osano E. Arakawa Y. Wacharotayankun R. Ohta M. Horii T. Ito H. (1994 ). Molecular characterization of an enterobacterial metallo beta-lactamase found in a clinical isolate of Serratia marcescens that shows imipenem resistance. Antimicrob. Agents Chemother. 38 71–78
Not in our library10.1128/aac.38.1.71
166.
Osterblad M. Kirveskari J. Hakanen A. J. Tissari P. Vaara M. Jalava J. (2012 ). Carbapenemase-producing Enterobacteriaceae in Finland: the first years (2008–11). J. Antimicrob. Chemother. 67 2860–2864
Not in our library10.1093/jac/dks299
167.
Page M. G. Dantier C. Desarbre E. (2010 ). In vitro properties of BAL30072, a novel siderophore sulfactam with activity against multiresistant Gram-negative bacilli. Antimicrob. Agents Chemother. 54 2291–2302
Not in our library10.1128/aac.01525-09
168.
Page M. G. Dantier C. Desarbre E. Gaucher B. Gebhardt K. Schmitt-Hoffmann A. (2011 ). In vitro and in vivo properties of BAL30376, a beta-lactam and dual beta-lactamase inhibitor combination with enhanced activity against Gram-negative bacilli that express multiple beta-lactamases. Antimicrob. Agents Chemother. 55 1510–1519
Not in our library10.1128/aac.01370-10
169.
Palepou M. F. Woodford N. Hope R. Colman M. Glover J. Kaufmann M. (eds). (2005 ). “Novel class A carbapenemase KPC-4, in an Enterobacter isolate from Scotland, abstr. 1134_01_20,” in Program and Abstracts of the 15th European Congress of Clinical Microbiology and Infectious Diseases, Copenhagen.
Not in our library
170.
Papp-Wallace K. M. Bethel C. R. Distler A. M. Kasuboski C. Taracila M. Bonomo R. A. (2010 ). Inhibitor resistance in the KPC-2 beta-lactamase, a preeminent property of this class A beta-lactamase. Antimicrob. Agents Chemother. 54 890–897
Not in our library10.1128/aac.00693-09
171.
Patel G. Bonomo R. A. (2011 ). Status report on carbapenemases: challenges and prospects. Expert Rev. Anti Infect. Ther. 9 555–570
Not in our library10.1586/eri.11.28
172.
Patel G. Huprikar S. Factor S. H. Jenkins S. G. Calfee D. P. (2008 ). Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect. Control Hosp. Epidemiol. 29 1099–1106
Not in our library10.1086/592412
173.
Paterson D. L. Bonomo R. A. (2005 ). Extended-spectrum beta-lactamases: a clinical update. Clin. Microbiol. Rev. 18 657–686
Not in our library10.1128/cmr.18.4.657-686.2005
174.
Paton R. Miles R. S. Hood J. Amyes S. G. (1993 ). ARI 1: beta-lactamase-mediated imipenem resistance in Acinetobacter baumannii. Int. J. Antimicrob. Agents 2 81–87
Not in our library10.1016/0924-8579(93)90045-7
175.
Peirano G. Schreckenberger P. C. Pitout J. D. (2011 ). Characteristics of NDM-1-producing Escherichia coli isolates that belong to the successful and virulent clone ST131. Antimicrob. Agents Chemother. 55 2986–2988
Not in our library10.1128/aac.01763-10
176.
Perez F. Endimiani A. Ray A. J. Decker B. K. Wallace C. J. Hujer K. M. (2010a ). Carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae across a hospital system: impact of post-acute care facilities on dissemination. J. Antimicrob. Chemother. 65 1807–1818
Not in our library10.1093/jac/dkq191
177.
Perez F. Hujer A. M. Hulten E. A. Fishbain J. Hujer K. M. Aron D. (2010b ). Antibiotic resistance determinants in Acinetobacter spp and clinical outcomes in patients from a major military treatment facility. Am. J. Infect. Control 38 63–65
Not in our library10.1016/j.ajic.2009.05.007
178.
Perez F. Hujer A. M. Hujer K. M. Decker B. K. Rather P. N. Bonomo R. A. (2007 ). Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob. Agents Chemother. 51 3471–3484
Not in our library10.1128/aac.01464-06
179.
Pfeifer Y. Schlatterer K. Engelmann E. Schiller R. A. Frangenberg H. R. Stiewe D. (2012 ). Emergence of OXA-48-type carbapenemase-producing Enterobacteriaceae in German hospitals. Antimicrob. Agents Chemother. 56 2125–2128
Not in our library10.1128/aac.05315-11
180.
Pfeifer Y. Wilharm G. Zander E. Wichelhaus T. A. Göttig S. Hunfeld K.-P. (2011a ). Molecular characterization of blaNDM-1 in an Acinetobacter baumannii strain isolated in Germany in 2007. J. Antimicrob. Chemother. 66 1998–2001
Not in our library10.1093/jac/dkr256
181.
Pfeifer Y. Witte W. Holfelder M. Busch J. Nordmann P. Poirel L. (2011b ). NDM-1-producing Escherichia coli in Germany. Antimicrob. Agents Chemother. 55 1318–1319
Not in our library10.1128/aac.01585-10
182.
Poirel L. Al Maskari Z. Al Rashdi F. Bernabeu S. Nordmann P. (2010a ). NDM-1-producing Klebsiella pneumoniae isolated in the Sultanate of Oman. J. Antimicrob. Chemother. 66 304–306
Not in our library10.1093/jac/dkq428
183.
Poirel L. Naas T. Nordmann P. (2010b ). Diversity, epidemiology, and genetics of class D beta-lactamases. Antimicrob. Agents Chemother. 54 24–38
Not in our library10.1128/aac.01512-08
184.
Poirel L. Rodriguez-Martinez J.-M. Al Naiemi N. Debets-Ossenkopp Y. J. Nordmann P. (2010c ). Characterization of DIM-1, an integron-encoded metallo-beta-lactamase from a Pseudomonas stutzeri clinical isolate in the Netherlands. Antimicrob. Agents Chemother. 54 2420–2424
Not in our library10.1128/aac.01456-09
185.
Poirel L. Bonnin R. A. Boulanger A. Schrenzel J. Kaase M. Nordmann P. (2012a ). Tn125-related acquisition of blaNDM-like genes in Acinetobacter baumannii. Antimicrob. Agents Chemother. 56 1087–1089
Not in our library10.1128/aac.05620-11
186.
Poirel L. Bonnin R. A. Nordmann P. (2012b ). Genetic features of the widespread plasmid coding for the carbapenemase OXA-48. Antimicrob. Agents Chemother. 56 559–562
Not in our library10.1128/aac.05289-11
187.
Poirel L. Potron A. Nordmann P. (2012c ). OXA-48-like carbapenemases: the phantom menace. J. Antimicrob. Chemother. 67 1597–1606
Not in our library10.1093/jac/dks121
188.
Poirel L. Bonnin R. A. Nordmann P. (2011a ). Analysis of the resistome of a multidrug-resistant NDM-1-producing Escherichia coli strain by high-throughput genome sequencing. Antimicrob. Agents Chemother. 55 4224–4229
Not in our library10.1128/aac.00165-11
189.
Poirel L. Castanheira M. Carrer A. Rodriguez C. P. Jones R. N. Smayevsky J. (2011b ). OXA-163, an OXA-48-related class D beta-lactamase with extended activity toward expanded-spectrum cephalosporins. Antimicrob. Agents Chemother. 55 2546–2551
Not in our library10.1128/aac.00022-11
190.
Poirel L. Dortet L. Bernabeu S. Nordmann P. (2011c ). Genetic features of blaNDM-1-positive Enterobacteriaceae. Antimicrob. Agents Chemother. 55 5403–5407
Not in our library10.1128/aac.00585-11
191.
Poirel L. Fortineau N. Nordmann P. (2011d ). International transfer of NDM-1-producing Klebsiella pneumoniae from Iraq to France. Antimicrob. Agents Chemother. 55 1821–1822
Not in our library10.1128/aac.01761-10
192.
Poirel L. Ros A. Carrer A. Fortineau N. Carricajo A. Berthelot P. (2011e ). Cross-border transmission of OXA-48-producing Enterobacter cloacae from Morocco to France. J. Antimicrob. Chemother. 66 1181–1182
Not in our library10.1093/jac/dkr023
193.
Poirel L. Héritier C. Nordmann P. (2004a ). Chromosome-encoded ambler class D beta-lactamase of Shewanella oneidensis as a progenitor of carbapenem-hydrolyzing oxacillinase. Antimicrob. Agents Chemother. 48 348–351
Not in our library10.1128/aac.48.1.348-351.2004
194.
Poirel L. Héritier C. Nordmann P. (2004b ). Chromosome-encoded ambler class D β-lactamase of Shewanella oneidensis as a progenitor of carbapenem-hydrolyzing oxacillinase. Antimicrob. Agents Chemother. 48 348–351
Not in our library10.1128/aac.48.1.348-351.2004
195.
Poirel L. Héritier C. Tolun V. Nordmann P. (2004c ). Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrob. Agents Chemother. 48 15–22
Not in our library10.1128/aac.48.1.15-22.2004
196.
Poirel L. Le Thomas I. Naas T. Karim A. Nordmann P. (2000a ). Biochemical sequence analyses of GES-1, a novel class A extended-spectrum beta-lactamase, and the class 1 integron In52 from Klebsiella pneumoniae. Antimicrob. Agents Chemother. 44 622–632
Not in our library10.1128/aac.44.3.622-632.2000
197.
Poirel L. Naas T. Nicolas D. Collet L. Bellais S. Cavallo J.-D. (2000b ). Characterization of VIM-2, a carbapenem-hydrolyzing metallo-beta-lactamase and its plasmid- and integron-borne gene from a Pseudomonas aeruginosa clinical isolate in France. Antimicrob. Agents Chemother. 44 891–897
Not in our library10.1128/aac.44.4.891-897.2000
198.
Poirel L. Marqué S. Héritier C. Segonds C. Chabanon G. Nordmann P. (2005 ). OXA-58, a novel class D beta-lactamase involved in resistance to carbapenems in Acinetobacter baumannii. Antimicrob. Agents Chemother. 49 202–208
Not in our library10.1128/aac.49.1.202-208.2005
199.
Poirel L. Nordmann P. (2006 ). Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin. Microbiol. Infect. 12 826–836
Not in our library10.1111/j.1469-0691.2006.01456.x
200.
Poirel L. Weldhagen G. F. De Champs C. Nordmann P. (2002 ). A nosocomial outbreak of Pseudomonas aeruginosa isolates expressing the extended-spectrum β-lactamase GES-2 in South Africa. J. Antimicrob. Chemother. 49 561–565
Not in our library10.1093/jac/49.3.561
201.
Poirel L. Wenger A. Bille J. Bernabeu S. Naas T. Nordmann P. (2007 ). SME-2-producing Serratia marcescens isolate from Switzerland. Antimicrob. Agents Chemother. 51 2282–2283
Not in our library10.1128/aac.00309-07
202.
Pollini S. Maradei S. Pecile P. Olivo G. Luzzaro F. Docquier J. D. (2012 ). FIM-1, a new acquired metallo-beta-lactamase from a Pseudomonas aeruginosa clinical isolate from Italy. Antimicrob. Agents Chemother. 57 410–416
Not in our library10.1128/aac.01953-12
203.
Potron A. Kalpoe J. Poirel L. Nordmann P. (2011a ). European dissemination of a single OXA-48-producing Klebsiella pneumoniae clone. Clin. Microbiol. Infect. 17 E24–E26
Not in our library10.1111/j.1469-0691.2011.03669.x
204.
Potron A. Poirel L. Nordmann P. (2011b ). Origin of OXA-181, an emerging carbapenem-hydrolyzing oxacillinase, as a chromosomal gene in Shewanella xiamenensis. Antimicrob. Agents Chemother. 55 4405–4407
Not in our library10.1128/aac.00681-11
205.
Potron A. Nordmann P. Poirel L. (2013 ). Characterization of OXA-204, a carbapenem-hydrolyzing class D β-lactamase from Klebsiella pneumoniae. Antimicrob. Agents Chemother. 57 633–636
Not in our library10.1128/aac.01034-12
206.
NmcA Carbapenem-hydrolyzing Enzyme in Enterobacter cloacae in North America · 2003
Not checked
207.
Poudyal A. Howden B. P. Bell J. M. Gao W. Owen R. J. Turnidge J. D. (2008 ). In vitro pharmacodynamics of colistin against multidrug-resistant Klebsiella pneumoniae. J. Antimicrob. Chemother. 62 1311–1318
Not in our library10.1093/jac/dkn425
208.
Prabaker K. Lin M. Y. McNally M. Cherabuddi K. Ahmed S. Norris A. (2012 ). Transfer from high-acuity long-term care facilities is associated with carriage of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae: a multihospital study. Infect. Control Hosp. Epidemiol. 33 1193–1199
Not in our library10.1086/668435
209.
Qi Y. Wei Z. Ji S. Du X. Shen P. Yu Y. (2011 ). ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China. J. Antimicrob. Chemother. 66 307–312
Not in our library10.1093/jac/dkq431
210.
Queenan A. M. Shang W. Schreckenberger P. Lolans K. Bush K. Quinn J. (2006 ). SME-3, a novel member of the Serratia marcescens SME family of carbapenem-hydrolyzing beta-lactamases. Antimicrob. Agents Chemother. 50 3485–3487
Not in our library10.1128/aac.00363-06
211.
Queenan A. M. Torres-Viera C. Gold H. S. Carmeli Y. Eliopoulos G. M. Moellering R. C. Jr., et al. (2000 ). SME-type carbapenem-hydrolyzing class A beta-lactamases from geographically diverse Serratia marcescens strains. Antimicrob. Agents Chemother. 44 3035–3039
Not in our library10.1128/aac.44.11.3035-3039.2000
212.
Qureshi Z. A. Paterson D. L. Potoski B. A. Kilayko M. C. Sandovsky G. Sordillo E. (2012 ). Treatment outcome of bacteremia due to KPC-producing Klebsiella pneumoniae: superiority of combination antimicrobial regimens. Antimicrob. Agents Chemother. 56 2108–2113
Not in our library10.1128/aac.06268-11
213.
Rasheed J. K. Biddle J. W. Anderson K. F. Washer L. Chenoweth C. Perrin J. (2008 ). Detection of the Klebsiella pneumoniae carbapenemase type 2 carbapenem-hydrolyzing enzyme in clinical isolates of Citrobacter freundii and K. oxytoca carrying a common plasmid. J. Clin. Microbiol. 46 2066–2069
Not in our library10.1128/jcm.02038-07
214.
Rasmussen B. Bush K. Keeney D. Yang Y. Hare R. O’Gara C. (1996 ). Characterization of IMI-1 beta-lactamase, a class A carbapenem- hydrolyzing enzyme from Enterobacter cloacae. Antimicrob. Agents Chemother. 40 2080–2086
Not in our library10.1128/aac.40.9.2080
215.
Riccio M. L. Franceschini N. Boschi L. Caravelli B. Cornaglia G. Fontana R. (2000 ). Characterization of the metallo-beta-lactamase determinant of Acinetobacter baumannii AC-54/97 reveals the existence of bla(IMP) allelic variants carried by gene cassettes of different phylogeny. Antimicrob. Agents Chemother. 44 1229–1235
Not in our library10.1128/aac.44.5.1229-1235.2000
216.
Rice L. B. Carias L. L. Hutton R. A. Rudin S. D. Endimiani A. Bonomo R. A. (2008 ). The KQ element, a complex genetic region conferring transferable resistance to carbapenems, aminoglycosides, and fluoroquinolones in Klebsiella pneumoniae. Antimicrob. Agents Chemother. 52 3427–3429
Not in our library10.1128/aac.00493-08
217.
Robledo I. E. Aquino E. E. Sante M. I. Santana J. L. Otero D. M. Leon C. F. (2010 ). Detection of KPC in Acinetobacter spp. in Puerto Rico. Antimicrob. Agents Chemother. 54 1354–1357
Not in our library10.1128/aac.00899-09
218.
Robledo I. E. Moland E. S. Aquino E. A. Vazquez G. J. Sante M. I. Bertran J. (2007 ). “First report of a KPC-4 and CTX-M producing K. pneumoniae (KP) isolated from Puerto Rico, abstr. C2-1933,” in 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (Washington, DC: American Society for Microbiology)
Not in our library
219.
Robledo I. E. Vázquez G. J. Aquino E. A. Moland E. S. Santé M. I. Hanson N. D. (2008 ). “A novel KPC variant, KPC-6, in a Klebsiella pneumoniae (Kp) isolated in Puerto Rico (PR), abstr. C2-3738,” in 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy and the 46th Annual Meeting of Infectious Diseases Society of America (Washington, DC: American Society for Microbiology)
Not in our library
220.
Rodriguez-Rojas A. Couce A. Blazquez J. (2010 ). Frequency of spontaneous resistance to fosfomycin combined with different antibiotics in Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 54 4948–4949
Not in our library10.1128/aac.00415-10
221.
Rodvold K. A. Gotfried M. H. Cwik M. Korth-Bradley J. M. Dukart G. Ellis-Grosse E. J. (2006 ). Serum, tissue and body fluid concentrations of tigecycline after a single 100 mg dose. J. Antimicrob. Chemother. 58 1221–1229
Not in our library10.1093/jac/dkl403
222.
Rogers B. A. Aminzadeh Z. Hayashi Y. Paterson D. L. (2011 ). Country-to-country transfer of patients and the risk of multi-resistant bacterial infection. Clin. Infect. Dis. 53 49–56
Not in our library10.1093/cid/cir273
223.
Rossi F. (2011 ). The challenges of antimicrobial resistance in Brazil. Clin. Infect. Dis. 52 1138–1143
Not in our library10.1093/cid/cir120
224.
Russo T. A. Page M. G. P. Beanan J. M. Olson R. Hujer A. M. Hujer K. M. (2011 ). In vivo and in vitro activity of the siderophore monosulfactam BAL30072 against Acinetobacter baumannii. J. Antimicrob. Chemother. 66 867–873
Not in our library10.1093/jac/dkr013
225.
Salabi A. E. Toleman M. A. Weeks J. Bruderer T. Frei R. Walsh T. R. (2010 ). First report of the metallo-beta-lactamase SPM-1 in Europe. Antimicrob. Agents Chemother. 54 582
Not in our library10.1128/aac.00719-09
226.
Samuelsen O. Naseer U. Tofteland S. Skutlaberg D. H. Onken A. Hjetland R. (2009 ). Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. J. Antimicrob. Chemother. 63 654–658
Not in our library10.1093/jac/dkp018
227.
Satlin M. J. Kubin C. J. Blumenthal J. S. Cohen A. B. Furuya E. Y. Wilson S. J. (2011 ). Comparative effectiveness of aminoglycosides, polymyxin B, and tigecycline for clearance of carbapenem-resistant Klebsiella pneumoniae from urine. Antimicrob. Agents Chemother. 55 5893–5899
Not in our library10.1128/aac.00387-11
228.
Schwaber M. J. Klarfeld-Lidji S. Navon-Venezia S. Schwartz D. Leavitt A. Carmeli Y. (2008 ). Predictors of carbapenem-resistant Klebsiella pneumoniae acquisition among hospitalized adults and effect of acquisition on mortality. Antimicrob. Agents Chemother. 52 1028–1033
Not in our library10.1128/aac.01020-07
229.
Schwaber M. J. Lev B. Israeli A. Solter E. Smollan G. Rubinovitch B. (2011 ). Containment of a country-wide outbreak of carbapenem-resistant Klebsiella pneumoniae in Israeli hospitals via a nationally implemented intervention. Clin. Infect. Dis. 52 848–855
Not in our library10.1093/cid/cir025
230.
Scott P. Deye G. Srinivasan A. Murray C. Moran K. Hulten E. (2007 ). An outbreak of multidrug-resistant Acinetobacter baumannii–calcoaceticus complex infection in the US military health care system associated with military operations in Iraq. Clin. Infect. Dis. 44 1577–1584
Not in our library10.1086/518170
231.
Sekiguchi J.-I. Morita K. Kitao T. Watanabe N. Okazaki M. Miyoshi-Akiyama T. (2008 ). KHM-1, a novel plasmid-mediated metallo-beta-lactamase from a Citrobacter freundii clinical isolate. Antimicrob. Agents Chemother. 52 4194–4197
Not in our library10.1128/aac.01337-07
232.
Shahid M. Sobia F. Singh A. Malik A. Khan H. M. Jonas D. (2009 ). Beta-lactams and beta-lactamase-inhibitors in current- or potential-clinical practice: a comprehensive update. Crit. Rev. Microbiol. 35 81–108
Not in our library10.1080/10408410902733979
233.
Snitkin E. S. Zelazny A. M. Thomas P. J. Stock F. Program N. C. S. Henderson D. K. (2012 ). Tracking a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae with whole-genome sequencing. Sci. Transl. Med. 4 148ra116
Not in our library10.1126/scitranslmed.3004129
234.
Souli M. Galani I. Boukovalas S. Gourgoulis M. G. Chryssouli Z. Kanellakopoulou K. (2011 ). In vitro interactions of antimicrobial combinations with fosfomycin against KPC-2-producing Klebsiella pneumoniae and protection of resistance development. Antimicrob. Agents Chemother. 55 2395–2397
Not in our library10.1128/aac.01086-10
235.
Struelens M. J. Monnet D. L. Magiorakos A. P. Santos O’Connor F. Giesecke J. (2010 ). New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe. Euro Surveill. 15. pii: 19716
Not in our library10.2807/ese.15.46.19716-en
236.
Sun Y. Cai Y. Liu X. Bai N. Liang B. Wang R. (2012 ). The emergence of clinical resistance to tigecycline. Int. J. Antimicrob. Agents 41 110–116
Not in our library10.1016/j.ijantimicag.2012.09.005
237.
Tasina E. Haidich A.-B. Kokkali S. Arvanitidou M. (2011 ). Efficacy and safety of tigecycline for the treatment of infectious diseases: a meta-analysis. Lancet Infect. Dis. 11 834–844
Not in our library10.1016/s1473-3099(11)70177-3
238.
Tibbetts R. Frye J. G. Marschall J. Warren D. Dunne W. (2008 ). Detection of KPC-2 in a clinical isolate of Proteus mirabilis and first reported description of carbapenemase resistance caused by a KPC beta-lactamase in P. mirabilis. J. Clin. Microbiol. 46 3080–3083
Not in our library10.1128/jcm.00979-08
239.
Tillotson G. (2010 ). Stimulating antibiotic development. Lancet Infect. Dis. 10 2–3
Not in our library10.1016/s1473-3099(09)70333-0
240.
Toleman M. A. Simm A. M. Murphy T. A. Gales A. C. Biedenbach D. J. Jones R. N. (2002 ). Molecular characterization of SPM-1, a novel metallo-β-lactamase isolated in Latin America: report from the SENTRY antimicrobial surveillance programme. J. Antimicrob. Chemother. 50 673–679
Not in our library10.1093/jac/dkf210
241.
Toleman M. A. Spencer J. Jones L. Walsh T. R. (2012 ). blaNDM-1 is a chimera likely constructed in Acinetobacter baumannii. Antimicrob. Agents Chemother. 56 2773–2776
Not in our library10.1128/aac.06297-11
242.
Tumbarello M. Viale P. Viscoli C. Trecarichi E. M. Tumietto F. Marchese A. (2012 ). Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy. Clin. Infect. Dis. 55 943–950
Not in our library10.1093/cid/cis588
243.
Urban C. Bradford P. A. Tuckman M. Segal-Maurer S. Wehbeh W. Grenner L. (2008 ). Carbapenem-resistant Escherichia coli harboring Klebsiella pneumoniae carbapenemase β-lactamases associated with long-term care facilities. Clin. Infect. Dis. 46 e127–e130
Not in our library10.1086/588048
244.
Urban C. Mariano N. Rahal J. J. (2010 ). In vitro double and triple bactericidal activities of doripenem, polymyxin B, and rifampin against multidrug-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli. Antimicrob. Agents Chemother. 54 2732–2734
Not in our library10.1128/aac.01768-09
245.
Vaara M. Sader H. S. Rhomberg P. R. Jones R. N. Vaara T. (2012 ). Antimicrobial activity of the novel polymyxin derivative NAB739 tested against Gram-negative pathogens. J. Antimicrob. Chemother. 68 636–639
Not in our library10.1093/jac/dks438
246.
Vaara M. Siikanen O. Apajalahti J. Frimodt-Moller N. Vaara T. (2010 ). Susceptibility of carbapenemase-producing strains of Klebsiella pneumoniae and Escherichia coli to the direct antibacterial activity of NAB739 and to the synergistic activity of NAB7061 with rifampicin and clarithromycin. J. Antimicrob. Chemother. 65 942–945
Not in our library10.1093/jac/dkq040
247.
van der Bij A. K. Pitout J. D. (2012 ). The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae. J. Antimicrob. Chemother. 67 2090–2100
Not in our library10.1093/jac/dks214
248.
Verde P. E. Curcio D. (2012 ). Imbalanced mortality evidence for tigecycline: 2011, the year of the meta-analysis. Clin. Infect. Dis. 55 471–472
Not in our library10.1093/cid/cis397
249.
Viau R. A. Hujer A. M. Marshall S. H. Perez F. Hujer K. M. Briceño D. F. (2012 ). “Silent” dissemination of Klebsiella pneumoniae isolates bearing K. pneumoniae carbapenemase in a long-term care facility for children and young adults in Northeast Ohio. Clin. Infect. Dis. 54 1314–1321
Not in our library10.1093/cid/cis036
250.
Villegas M. V. Lolans K. Correa A. Kattan J. N. Lopez J. A. Quinn J. P. (2007 ). First identification of Pseudomonas aeruginosa isolates producing a KPC-type carbapenem-hydrolyzing beta-lactamase. Antimicrob. Agents Chemother. 51 1553–1555
Not in our library10.1128/aac.01405-06
251.
Voulgari E. Zarkotou O. Ranellou K. Karageorgopoulos D. E. Vrioni G. Mamali V. (2012 ). Outbreak of OXA-48 carbapenemase-producing Klebsiella pneumoniae in Greece involving an ST11 clone. J. Antimicrob. Chemother. 68 84–88
Not in our library10.1093/jac/dks356
252.
Vourli S. Giakkoupi P. Miriagou V. Tzelepi E. Vatopoulos A. C. Tzouvelekis L. S. (2004 ). Novel GES/IBC extended-spectrum β-lactamase variants with carbapenemase activity in clinical enterobacteria. FEMS Microbiol. Lett. 234 209–213
Not in our library10.1016/j.femsle.2004.03.028
253.
Wachino J. Doi Y. Yamane K. Shibata N. Yagi T. Kubota T. (2004 ). Molecular characterization of a cephamycin-hydrolyzing and inhibitor-resistant class A beta-lactamase, GES-4, possessing a single G170S substitution in the omega-loop. Antimicrob. Agents Chemother. 48 2905–2910
Not in our library10.1128/aac.48.8.2905-2910.2004
254.
Wachino J. Yoshida H. Yamane K. Suzuki S. Matsui M. Yamagishi T. (2011 ). SMB-1, a novel subclass B3 metallo-beta-lactamase, associated with ISCR1 and a class 1 integron, from a carbapenem-resistant Serratia marcescens clinical isolate. Antimicrob. Agents Chemother. 55 5143–5149
Not in our library10.1128/aac.05045-11
255.
Walkty A. Decorby M. Lagace-Wiens P. R. Karlowsky J. A. Hoban D. J. Zhanel G. G. (2011 ). In vitro activity of ceftazidime combined with NXL104 versus Pseudomonas aeruginosa isolates obtained from patients in Canadian hospitals (CANWARD 2009 study). Antimicrob. Agents Chemother. 55 2992–2994
Not in our library10.1128/aac.01696-10
256.
Walsh T. R. Toleman M. A. Poirel L. Nordmann P. (2005 ). Metallo-beta-lactamases: the quiet before the storm? Clin. Microbiol. Rev. 18 306–325
Not in our library10.1128/cmr.18.2.306-325.2005
257.
Walsh T. R. Weeks J. Livermore D. M. Toleman M. A. (2011 ). Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study. Lancet Infect. Dis. 11 355–362
Not in our library10.1016/s1473-3099(11)70059-7
258.
Walther-Rasmussen J Høiby N. (2007 ). Class A carbapenemases. J. Antimicrob. Chemother. 60 470–482
Not in our library10.1093/jac/dkm226
259.
Wang Y. F. Dowzicky M. J. (2010 ). In vitro activity of tigecycline and comparators on Acinetobacter spp. isolates collected from patients with bacteremia and MIC change during the Tigecycline Evaluation and Surveillance Trial, 2004 to 2008. Diagn. Microbiol. Infect. Dis. 68 73–79
Not in our library10.1016/j.diagmicrobio.2010.04.002
260.
Werneck J. S. Picao R. C. Girardello R. Cayo R. Marguti V. Dalla-Costa L. (2011 ). Low prevalence of blaOXA-143 in private hospitals in Brazil. Antimicrob. Agents Chemother. 55 4494–4495; author reply 4495.
Not in our library10.1128/aac.00295-11
261.
Wolter D. J. Kurpiel P. M. Woodford N. Palepou M. F. Goering R. V. Hanson N. D. (2009 ). Phenotypic and enzymatic comparative analysis of the novel KPC variant KPC-5 and its evolutionary variants, KPC-2 and KPC-4. Antimicrob. Agents Chemother. 53 557–562
Not in our library10.1128/aac.00734-08
262.
Woodford N. Tierno P. M. Jr. Young K. Tysall L. Palepou M. F. Ward E. (2004 ). Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. Antimicrob. Agents Chemother. 48 4793–4799
Not in our library10.1128/aac.48.12.4793-4799.2004
263.
Woodford N. Turton J. F. Livermore D. M. (2011 ). Multiresistant Gram-negative bacteria: the role of high-risk clones in the dissemination of antibiotic resistance. FEMS Microbiol. Rev. 35 736–755
Not in our library10.1111/j.1574-6976.2011.00268.x
264.
Woodford N. Zhang J. Warner M. Kaufmann M. E. Matos J. Macdonald A. (2008 ). Arrival of Klebsiella pneumoniae producing KPC carbapenemase in the United Kingdom. J. Antimicrob. Chemother. 62 1261–1264
Not in our library10.1093/jac/dkn396
265.
Yahav D. Lador A. Paul M. Leibovici L. (2011 ). Efficacy and safety of tigecycline: a systematic review and meta-analysis. J. Antimicrob. Chemother. 66 1963–1971
Not in our library10.1093/jac/dkr242
266.
Yang Y. J. Wu P. J. Livermore D. M. (1990 ). Biochemical characterization of a beta-lactamase that hydrolyzes penems and carbapenems from two Serratia marcescens isolates. Antimicrob. Agents Chemother. 34 755–758
Not in our library10.1128/aac.34.5.755
267.
Yau W. Owen R. J. Poudyal A. Bell J. M. Turnidge J. D. Yu H. H. (2009 ). Colistin hetero-resistance in multidrug-resistant Acinetobacter baumannii clinical isolates from the Western Pacific region in the SENTRY antimicrobial surveillance programme. J. Infect. 58 138–144
Not in our library10.1016/j.jinf.2008.11.002
268.
Yigit H. Queenan A. M. Anderson G. J. Domenech-Sanchez A. Biddle J. W. Steward C. D. (2001 ). Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob. Agents Chemother. 45 1151–1161
Not in our library10.1128/aac.45.4.1151-1161.2001
269.
Yigit H. Queenan A. M. Rasheed J. K. Biddle J. W. Domenech-Sanchez A. Alberti S. (2003 ). Carbapenem-resistant strain of Klebsiella oxytoca harboring carbapenem-hydrolyzing beta-lactamase KPC-2. Antimicrob. Agents Chemother. 47 3881–3889
Not in our library10.1128/aac.47.12.3881-3889.2003
270.
Yong D. Toleman M. A. Giske C. G. Cho H. S. Sundman K. Lee K. (2009 ). Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob. Agents Chemother. 53 5046–5054
Not in our library10.1128/aac.00774-09
271.
Yong D. Walsh T. R. Bell J. Ritchie B. Pratt R. Toleman M. A. (2007 ). “A novel subgroup metallo β-lactamase, AIM-1, emerges in Pseudomonas aeruginosa from Australia abstr. C1-593,” in 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (Washington, DC: American Society for Microbiology)
Not in our library
272.
Yu Y.-S. Du X.-X. Zhou Z.-H. Chen Y.-G. Li L.-J. (2006 ). First isolation of blaIMI-2 in an Enterobacter cloacae clinical isolate from China. Antimicrob. Agents Chemother. 50 1610–1611
Not in our library10.1128/aac.50.4.1610-1611.2006
273.
Zarrilli R. Pournaras S. Giannouli M. Tsakris A. (2013 ). Global evolution of multidrug-resistant Acinetobacter baumannii clonal lineages. Int. J. Antimicrob. Agents 41 11–19
Not in our library10.1016/j.ijantimicag.2012.09.008
274.
Zhanel G. G. Lawson C. D. Zelenitsky S. Findlay B. Schweizer F. Adam H. (2012 ). Comparison of the next-generation aminoglycoside plazomicin to gentamicin, tobramycin and amikacin. Expert Rev. Anti Infect. Ther. 10 459–473
Not in our library10.1586/eri.12.25
275.
Zhang H. Hao Q. (2011 ). Crystal structure of NDM-1 reveals a common β-lactam hydrolysis mechanism. FASEB J. 25 2574–2582
Not in our library10.1096/fj.11-184036

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