{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:25:44Z","timestamp":1786969544000,"version":"build-2736575974"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"8","funder":[{"DOI":"10.13039\/100031003","name":"CDC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031003","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Emerging Infections Program","award":["CDC-RFA-CK17-1701"],"award-info":[{"award-number":["CDC-RFA-CK17-1701"]}]},{"name":"Genomic Sequencing Laboratory of the Biotechnology Core Facility Branch"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We described the changing epidemiology of New Delhi metallo-\u03b2-lactamase (NDM)\u2013producing carbapenem-resistant Enterobacterales (CRE) in 10 US sites conducting population-based CRE surveillance during 2018\u20132023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A CRE case was defined as the first isolation of Escherichia coli, Enterobacter spp., or Klebsiella spp. resistant to \u22651 carbapenem from a sterile site or urine in a surveillance area resident within a 30-day period. Cases were classified as healthcare-associated or community-associated. Incidence rates were calculated using census data; trends were assessed using the Mann\u2013Kendall test. Multivariable logistic regression was used to compare NDM- and Klebsiella pneumoniae carbapenemase-producing (KPC)\u2013CRE. A subset of isolates underwent whole-genome sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 2018\u20132023, CRE incidence increased from 5.34 to 7.65 per 100 000 population (P = .02). NDM-CRE incidence increased from 0.07 to 0.66 per 100 000 population (P = .02); no significant trend was observed for KPC-CRE. Odds of being an NDM-CRE case were increased for community-associated versus healthcare-associated cases (adjusted odds ratio [aOR], 3.2; 95% CI, 1.98\u20135.17) and for cases aged 0\u201324 years versus \u226575 years (aOR, 3.99; 95% CI, 1.59\u201310.02). Genomic analysis showed diversity of sequence types among NDM- versus KPC-CRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increases in CRE incidence appear to be driven by NDM-CRE, which are more likely than KPC-CRE to be community-associated. Continued surveillance is recommended to understand changes in epidemiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag477","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:06:04Z","timestamp":1785585964000},"source":"Crossref","is-referenced-by-count":0,"title":["Rising Incidence of New Delhi Metallo-\u03b2-Lactamase\u2013Producing Carbapenem-Resistant Enterobacterales, 10 US Sites, 2018\u20132023"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2347-3690","authenticated-orcid":false,"given":"Nadezhda","family":"Duffy","sequence":"first","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davina","family":"Campbell","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease 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