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The rapid emergence of penicillinases in both gram\u2010positive and gram\u2010negative bacteria led to the development of cephalosporin \u03b2\u2010lactam antibiotics, but production of plasmid\u2010mediated extended\u2010spectrum cephalosporinases (or extended\u2010spectrum \u03b2\u2010lactamases) and AmpC enzymes resulted in resistance to this drug class. Because carbapenems were the only \u03b2\u2010lactam agents active against such extended\u2010spectrum \u03b2\u2010lactamase\u2013producing strains, appropriate and inappropriate use soon resulted in Enterobacteriaceae resistance. As a result, two distinct types of carbapenemases\u2014the metallo\u2010\u03b2\u2010lactamases and\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    carbapenemases (\n                    <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\n                    s)\u2014were soon identified. The\n                    <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\n                    s comprise 10 variants that differ from one another by one to three amino acid substitutions (\n                    <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\n                    \u20102 to\n                    <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\n                    \u201011). The\n                    <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\n                    \u2010producing Enterobacteriaceae are not only multidrug resistant but are also difficult to detect routinely in the clinical microbiology laboratory. Tigecycline, polymyxins (colistin and polymyxin B), and aminoglycosides are possible candidate therapies for infections caused by\n                    <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\n                    \u2010producing organisms, although well\u2010conducted clinical trials are required to fully define their roles in patient management. 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