{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:56:09Z","timestamp":1791276969238,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI22\/01778"],"award-info":[{"award-number":["PI22\/01778"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI23\/00546"],"award-info":[{"award-number":["PI23\/00546"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023961","name":"Centro de Investigaci\u00f3n Biotecnol\u00f3gica en Red de Enfermedades Infecciosas","doi-asserted-by":"publisher","award":["CB21\/13\/00049"],"award-info":[{"award-number":["CB21\/13\/00049"]}],"id":[{"id":"10.13039\/501100023961","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Ther"],"DOI":"10.1007\/s40121-026-01453-x","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:48:44Z","timestamp":1791276524000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical-Microbiological Discordance and Delayed Mortality in OXA-48\/ESBL-Producing Proteus mirabilis Infections"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-0085","authenticated-orcid":false,"given":"Isabel","family":"Machuca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J.","family":"Pineda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Mar\u00edn-Sanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Riazzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Guzm\u00e1n-Puche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Cano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Moya-Riballo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelia","family":"De la Torre-Capit\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Berm\u00fadez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J.","family":"Cast\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"P\u00e9rez-Nadales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Kieffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Gracia-Ahufinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Ruiz-Arabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Carmona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Pozo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Cosano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Baumela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"de la Fuente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Mart\u00ednez-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1529-6302","authenticated-orcid":false,"given":"Juli\u00e1n","family":"Torre-Cisneros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"1453_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-017-0191-3","author":"L Xu","year":"2017","unstructured":"Xu L, Sun X, Ma X. Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae. Ann Clin Microbiol Antimicrob. 2017. https:\/\/doi.org\/10.1186\/s12941-017-0191-3.","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"1453_CR2","doi-asserted-by":"publisher","first-page":"3009","DOI":"10.1093\/jac\/dkac267","volume":"77","author":"R Pedraza","year":"2022","unstructured":"Pedraza R, Kieffer N, Guzm\u00e1n-Puche J, et al. Hidden dissemination of carbapenem-susceptible OXA-48-producing Proteus mirabilis. J Antimicrob Chemother. 2022;77:3009\u201315. https:\/\/doi.org\/10.1093\/jac\/dkac267.","journal-title":"J Antimicrob Chemother"},{"key":"1453_CR3","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2024.2353310","author":"J Sattler","year":"2024","unstructured":"Sattler J, Noster J, Stelzer Y, et al. OXA-48-like carbapenemases in Proteus mirabilis\u2013novel genetic environments and a challenge for detection. Emerg Microbes Infect. 2024. https:\/\/doi.org\/10.1080\/22221751.2024.2353310.","journal-title":"Emerg Microbes Infect"},{"key":"1453_CR4","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1080\/22221751.2020.1773322","volume":"9","author":"X Hua","year":"2020","unstructured":"Hua X, Zhang L, Moran RA, et al. Cointegration as a mechanism for the evolution of a KPC-producing multidrug resistance plasmid in Proteus mirabilis. Emerg Microbes Infect. 2020;9:1206\u201318. https:\/\/doi.org\/10.1080\/22221751.2020.1773322.","journal-title":"Emerg Microbes Infect"},{"key":"1453_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms13030508","author":"B Bedeni\u0107","year":"2025","unstructured":"Bedeni\u0107 B, Pospi\u0161il M, Na\u0111 M, Bandi\u0107 Pavlovi\u0107 D. Evolution of \u03b2-lactam antibiotic resistance in Proteus species: from extended-spectrum and plasmid-mediated AmpC \u03b2-lactamases to carbapenemases. Microorganisms. 2025. https:\/\/doi.org\/10.3390\/microorganisms13030508.","journal-title":"Microorganisms"},{"key":"1453_CR6","doi-asserted-by":"publisher","unstructured":"Aires-De-Sousa M, Ortiz De La Rosa JM, Goncalves ML, Costa A, Nordmann P, Poirel L. Occurrence of NDM-1-producing Morganella morganii and Proteus mirabilis in a single patient in Portugal: probable in vivo transfer by conjugation. J Antimicrob Chemother. 2020;75:903\u2013906. https:\/\/doi.org\/10.1093\/jac\/dkz542","DOI":"10.1093\/jac\/dkz542"},{"key":"1453_CR7","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.jgar.2019.01.030","volume":"18","author":"H Boudjemaa","year":"2019","unstructured":"Boudjemaa H, Allem R, Fonkou MDM, Zouagui S, Khennouchi NCelH, Kerkoud M. Molecular drivers of emerging multidrug resistance in Proteus mirabilis clinical isolates from Algeria. J Glob Antimicrob Resist. 2019;18:249\u201356. https:\/\/doi.org\/10.1016\/j.jgar.2019.01.030.","journal-title":"J Glob Antimicrob Resist"},{"key":"1453_CR8","doi-asserted-by":"publisher","first-page":"1678","DOI":"10.1128\/aac.01947-13","volume":"58","author":"DE Wiskirchen","year":"2014","unstructured":"Wiskirchen DE, Nordmann P, Crandon JL, Nicolau DP. Efficacy of humanized carbapenem and ceftazidime regimens against enterobacteriaceae producing OXA-48 carbapenemase in a murine infection model. Antimicrob Agents Chemother. 2014;58:1678\u201383. https:\/\/doi.org\/10.1128\/aac.01947-13.","journal-title":"Antimicrob Agents Chemother"},{"key":"1453_CR9","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01195-18","author":"A Stewart","year":"2018","unstructured":"Stewart A, Harris P, Henderson A, Paterson D. Treatment of infections by OXA-48-producing Enterobacteriaceae. Antimicrob Agents Chemother. 2018. https:\/\/doi.org\/10.1128\/aac.01195-18.","journal-title":"Antimicrob Agents Chemother"},{"key":"1453_CR10","unstructured":"European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals, 2022\u20132023. https:\/\/www.ecdc.europa.eu\/en\/publications-data\/PPS-HAI-AMR-acute-care-europe-2022-2023. Accessed May 16, 2025."},{"key":"1453_CR11","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1159\/000521288","volume":"91","author":"ME Charlson","year":"2022","unstructured":"Charlson ME, Carrozzino D, Guidi J, Patierno C. Charlson comorbidity index: a critical review of clinimetric properties. Psychother Psychosom. 2022;91:8\u201335. https:\/\/doi.org\/10.1159\/000521288.","journal-title":"Psychother Psychosom"},{"key":"1453_CR12","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1016\/j.mayocp.2016.06.024","volume":"91","author":"B Guti\u00e9rrez-Guti\u00e9rrez","year":"2016","unstructured":"Guti\u00e9rrez-Guti\u00e9rrez B, Salamanca E, de Cueto M, et al. A predictive model of mortality in patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae. Mayo Clin Proc. 2016;91:1362\u201371. https:\/\/doi.org\/10.1016\/j.mayocp.2016.06.024.","journal-title":"Mayo Clin Proc"},{"key":"1453_CR13","unstructured":"Centers for Disease Control and Prevention (CDC). 2016 HAI Progress Report. https:\/\/www.cdc.gov\/hai\/data\/archive\/2016-HAI-progress-report.html. Accessed July 1, 2020."},{"key":"1453_CR14","unstructured":"European Committee on Antimicrobial Susceptibility Testing (EUCAST). Clinical breakpoints. https:\/\/www.eucast.org\/clinical_breakpoints. Accessed August 7, 2025."},{"key":"1453_CR15","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.mimet.2016.11.013","volume":"132","author":"K Yamada","year":"2017","unstructured":"Yamada K, Kashiwa M, Arai K, Nagano N, Saito R. Evaluation of the modified carbapenem inactivation method and sodium mercaptoacetate-combination method for the detection of metallo-\u03b2-lactamase production by carbapenemase-producing Enterobacteriaceae. J Microbiol Methods. 2017;132:112\u20135. https:\/\/doi.org\/10.1016\/j.mimet.2016.11.013.","journal-title":"J Microbiol Methods"},{"key":"1453_CR16","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1007\/S15010-019-01326-1","volume":"47","author":"N Kieffer","year":"2019","unstructured":"Kieffer N, Poirel L, Nordmann P. Rapid immunochromatography-based detection of carbapenemase producers. Infection. 2019;47:673\u20135. https:\/\/doi.org\/10.1007\/S15010-019-01326-1.","journal-title":"Infection"},{"issue":"4","key":"1453_CR17","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00181-24","volume":"38","author":"LK Muhsal","year":"2025","unstructured":"Muhsal LK, Theis L, Overmann J, Hamprecht A. Proteus spp.\u2014taxonomy, clinical significance, and antibiotic resistance of a highly versatile pathogen. Clin Microbiol Rev. 2025;38(4):e0018124. https:\/\/doi.org\/10.1128\/cmr.00181-24.","journal-title":"Clin Microbiol Rev"},{"key":"1453_CR18","doi-asserted-by":"publisher","first-page":"1198.e1","DOI":"10.1016\/j.cmi.2023.05.032","volume":"29","author":"A Hamprecht","year":"2023","unstructured":"Hamprecht A, Sattler J, Noster J, et al. Proteus mirabilis\u2014analysis of a concealed source of carbapenemases and development of a diagnostic algorithm for detection. Clin Microbiol Infect. 2023;29:1198.e1-1198.e6. https:\/\/doi.org\/10.1016\/j.cmi.2023.05.032.","journal-title":"Clin Microbiol Infect"},{"key":"1453_CR19","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.ijid.2022.03.025","volume":"119","author":"L Corbella","year":"2022","unstructured":"Corbella L, Fern\u00e1ndez-Ruiz M, Ruiz-Ruig\u00f3mez M, et al. Prognostic factors of OXA-48 carbapenemase-producing Klebsiella pneumoniae infection in a tertiary-care Spanish hospital: a retrospective single-center cohort study. Int J Infect Dis. 2022;119:59\u201368. https:\/\/doi.org\/10.1016\/j.ijid.2022.03.025.","journal-title":"Int J Infect Dis"},{"key":"1453_CR20","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00273-25","author":"JN Ngiam","year":"2025","unstructured":"Ngiam JN, Chung M, Koh Y, et al. Clinical outcomes of phenotype-guided treatment in group D carbapenemase-producing Enterobacterales bacteremia. Microbiol Spectr. 2025. https:\/\/doi.org\/10.1128\/spectrum.00273-25.","journal-title":"Microbiol Spectr"},{"key":"1453_CR21","unstructured":"European Committee on Antimicrobial Susceptibility Testing (EUCAST). Public consultations. https:\/\/www.eucast.org\/publications-and-documents\/consultations. Accessed August 7, 2025."},{"key":"1453_CR22","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae403","author":"PD Tamma","year":"2024","unstructured":"Tamma PD, Heil EL, Justo JA, Mathers AJ, Satlin MJ, Bonomo RA. Infectious Diseases Society of America 2024 guidance on the treatment of antimicrobial-resistant Gram-negative infections. Clin Infect Dis. 2024. https:\/\/doi.org\/10.1093\/cid\/ciae403.","journal-title":"Clin Infect Dis"},{"key":"1453_CR23","doi-asserted-by":"publisher","first-page":"e00883-17","DOI":"10.1128\/aac.00883-17","volume":"61","author":"RK Shields","year":"2017","unstructured":"Shields RK, Nguyen MH, Chen L, et al. Ceftazidime-avibactam is superior to other treatment regimens against carbapenem-resistant Klebsiella pneumoniae bacteremia. Antimicrob Agents Chemother. 2017;61:e00883-17. https:\/\/doi.org\/10.1128\/aac.00883-17.","journal-title":"Antimicrob Agents Chemother"},{"key":"1453_CR24","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/j.ijantimicag.2019.07.017","volume":"54","author":"I Machuca","year":"2019","unstructured":"Machuca I, Guti\u00e9rrez-Guti\u00e9rrez B, Rivera-Espinar F, et al. External validation of the INCREMENT-CPE mortality score in a carbapenem-resistant Klebsiella pneumoniae bacteraemia cohort: the prognostic significance of colistin resistance. Int J Antimicrob Agents. 2019;54:442\u20138. https:\/\/doi.org\/10.1016\/j.ijantimicag.2019.07.017.","journal-title":"Int J Antimicrob Agents"},{"key":"1453_CR25","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1093\/cid\/cix991","volume":"66","author":"A Cano","year":"2018","unstructured":"Cano A, Guti\u00e9rrez-Guti\u00e9rrez B, Machuca I, et al. Risks of infection and mortality among patients colonized with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: validation of scores and proposal for management. Clin Infect Dis. 2018;66:1204\u201310. https:\/\/doi.org\/10.1093\/cid\/cix991.","journal-title":"Clin Infect Dis"}],"container-title":["Infectious Diseases and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40121-026-01453-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40121-026-01453-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40121-026-01453-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:48:48Z","timestamp":1791276528000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40121-026-01453-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":25,"alternative-id":["1453"],"URL":"https:\/\/doi.org\/10.1007\/s40121-026-01453-x","relation":{},"ISSN":["2193-8229","2193-6382"],"issn-type":[{"value":"2193-8229","type":"print"},{"value":"2193-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"18 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Isabel Machuca has served as consultant for Advanz, received consulting fees from Shionogi and Advanz, honoraria for lectures from Shionogi, Advanz, Menarini, and Pfizer, and travel support from Shionogi, Menarini, and Pfizer. Jorge Rodr\u00edguez-G\u00f3mez has received lecture honoraria from MSD Espa\u00f1a and travel support from Pfizer. Irene Gracia-Ahufinger has received meeting support from Beckman Coulter and Menarini. \u00c1ngela Cano Yuste received research funding from ISCIII (PI23\/00403), CIBERINFEC (21\/13\/00012), and a postdoctoral contract from the Andalusian Regional Government. Juan Jos\u00e9 Cast\u00f3n has served as consultant for Menarini and Qiagen, received consulting fees from Advanz, honoraria for lectures from Shionogi, Advanz, Menarini, and Pfizer, and travel support from Shionogi, Menarini, and Pfizer. Carmen de la Fuente has received honoraria for lectures from Shionogi, Pfizer, and Gilead; travel support from Pfizer and Shionogi; and has served on advisory boards for Shionogi and Advanz. Luis Mart\u00ednez-Mart\u00ednez has served as consultant for MSD, Shionogi, and Pfizer; speaker for Pfizer, MSD, AstraZeneca, Astellas, Menarini, Roche, and Shionogi; and received research support from Pfizer, MSD, Janssen Cilag, Shionogi, and Advanz. Juli\u00e1n Torre-Cisneros has served as scientific advisor for Pfizer and InfectoPharm and received payments for lectures and educational activities from Pfizer, AstraZeneca, and Merck. Juan J. Pineda, Juan A. Mar\u00edn-Sanz, Cristina Riazzo, Julia Guzm\u00e1n-Puche, Raquel Moya-Riballo, Noelia De la Torre-Capit\u00e1n, Carmen Berm\u00fadez, Elena P\u00e9rez-Nadales, Nicolas Kieffer, Elisa Ruiz-Arabi, Isabel Carmona, Lorena Pozo, Patricia Cosano, and Andr\u00e9s Baumela declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received approval from the Ethics Committee of Reina Sofia Hospital, C\u00f3rdoba (SICEIA-2024-001306). Informed consent was waived because of the retrospective design. It was conducted in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) recommendations for observational studies (Table\n                      \n                      ). Patients were not involved in the design, conduct, or reporting of this study.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}