{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:05:03Z","timestamp":1781082303140,"version":"3.54.1"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP) and complicated intra-abdominal infections (cIAIs) caused by carbapenem-resistant Enterobacterales (CRE) are associated with high mortality. Metallo-\u03b2-lactamase (MBL)-producing strains represent therapeutic challenge compromising \u03b2-lactams and limiting treatment options. Aztreonam\/avibactam is a novel combination designed to overcome MBL-mediated resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate in vitro activity of aztreonam\/avibactam and comparators against Enterobacterales from patients with HAP, VAP or cIAI collected globally (Africa\/Middle East, Asia-Pacific, Europe and Latin America) during 2021\u201322 ATLAS surveillance program focusing on MBL-positive strains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>14\u200a564 Enterobacterales isolates were tested by broth microdilution per CLSI guidelines. CRE isolates underwent molecular characterization and MBL-positive isolates underwent additional molecular and susceptibility analysis, including cefiderocol. MBL-positive Escherichia coli isolates were screened for PBP3 mutations by whole-genome sequencing. MICs were interpreted using EUCAST breakpoints as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Aztreonam\/avibactam was 99.5% susceptible (MIC \u22644\u2005mg\/L) for all Enterobacterales (MIC90 0.25\u2005mg\/L) and maintained high susceptibility against MDR (98.9%), ESBL (99.0%) and CRE (96.4%). Among 577 MBL-positive isolates (88% NDM), aztreonam\/avibactam was 95.1% susceptible, compared with cefiderocol (50.3%), colistin (73.8%) and tigecycline (95.0%). Activity was consistent across regions and carbapenemase genotypes, including co-producers of multiple \u03b2-lactamases. However, E. coli isolates harbouring PBP3 insertions (YRIK\/YRIN) and plasmid-mediated AmpC \u03b2-lactamases (n\u200a=\u200a35) were 31.4% susceptible (MIC \u22644\u2005mg\/L).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Aztreonam\/avibactam demonstrated potent and consistent in vitro activity against Enterobacterales causing serious hospital infections, including MBL-producing CRE. These findings underscore aztreonam\/avibactam\u2019s therapeutic potential and the need for rapid diagnostics and global surveillance to guide regional stewardship and treatment strategies for MDR infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag198","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:42:39Z","timestamp":1779968559000},"source":"Crossref","is-referenced-by-count":0,"title":["<i>In vitro<\/i>\n                    activity of aztreonam\/avibactam and comparators against Enterobacterales isolates from patients with hospital-acquired pneumonia, ventilator-associated pneumonia, and complicated intra-abdominal infections (ATLAS, 2021\u20132022)"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7272-3900","authenticated-orcid":false,"given":"Qiwen","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, State Key Laboratory of Complex 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