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Remarkably, these enzymes have disseminated globally at an unprecedented rate. Therapeutic management of MBL-producing pathogens remains a major challenge because the enzymes are not inhibited by currently available \u03b2-lactamase inhibitors, and most pathogens that harbour MBLs are equipped with mechanisms of resistance to all available antibiotic classes. Recent advances have elucidated the biochemical and structural function of diverse MBLs thereby improving the development of future antibiotics. In this review, we summarize the contemporary global epidemiology of clinically relevant MBLs, describe the molecular mechanisms driving their dissemination and evaluate current and emerging therapeutic strategies for infections caused by MBL-producing gram-negative pathogens including Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia.<\/jats:p>","DOI":"10.1093\/jacamr\/dlag221","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:39:52Z","timestamp":1790681992000},"source":"Crossref","is-referenced-by-count":0,"title":["The global epidemiology and treatment of metallo-\u03b2-lactamase-producing gram-negative pathogens"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-2225","authenticated-orcid":false,"given":"Erin K","family":"McCreary","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pittsburgh , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6644-6684","authenticated-orcid":false,"given":"Emily L","family":"Heil","sequence":"additional","affiliation":[{"name":"Department of Practice, Sciences, and Health-Outcomes Research, University of Maryland School of Pharmacy , Baltimore, MD 21201 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8659-4238","authenticated-orcid":false,"given":"Samuel L","family":"Aitken","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Michigan College of Pharmacy , Ann Arbor, MI ,","place":["USA"]},{"name":"Department of Pharmacy, Michigan Medicine , Ann Arbor, MI ,","place":["USA"]},{"name":"Division of Infectious Diseases, University of Michigan Medical School , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-9824","authenticated-orcid":false,"given":"Maria F","family":"Mojica","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine , 9501 Euclid Ave, Cleveland, OH 44106 ,","place":["USA"]},{"name":"Research Service, Veterans Affairs Northeast Ohio Healthcare System , Cleveland, OH ,","place":["USA"]},{"name":"CASE-VA Center for Antimicrobial Resistance and Epidemiology , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4780-6215","authenticated-orcid":false,"given":"Jason M","family":"Pogue","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Michigan College of Pharmacy , Ann Arbor, MI ,","place":["USA"]},{"name":"Department of Pharmacy, Michigan Medicine , Ann 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