{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:56:02Z","timestamp":1791582962144,"version":"4.3.4"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T00:00:00Z","timestamp":1552608000000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"JMI Laboratories"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A total of 178 825 Enterobacteriaceae isolates collected in 199 hospitals from 42 countries worldwide over 20 years (1997 to 2016) of the SENTRY Program were susceptibility tested by reference broth microdilution methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Trends in percentages over time were analyzed by the \u03c72 test. Results were reported as the percentage difference between the first (1997\u20132000) and the last (2013\u20132016) time period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Enterobacteriaceae exhibiting resistance to cephalosporins (extended-spectrum \u03b2-lactamase [ESBL] phenotype) and carbapenem resistance (CRE) significantly increased (P &amp;lt; 0.05; \u03c72 test) from 10.3% to 24.0% and 0.6% to 2.9%, respectively. Similar trends were noted for all regions and infection sources. Klebsiella pneumoniae mainly drove the CRE increase. Multidrug-resistance (MDR) rates significantly increased from 7.3% to 15.3% overall, with important trends in all regions and infection sources. Significant increases were noted for MDR K. pneumoniae and Escherichia coli, polymyxin-resistant K. pneumoniae (2.0% to 5.5% overall), and aminoglycoside-resistant E. coli (7.0% to 18.0%) and K. pneumoniae (18.1% to 26.9%) over time in North America and Latin America. Carbapenemase-encoding genes were screened after 2007, and the occurrence of these genes was compared for 2007\u20132009 and 2014\u20132016. Among 1298 CRE isolates from the 2 study periods, blaKPC was detected among 186 (49.7%) and 501 (54.2%) isolates in 2007\u20132009 and 2014\u20132016, respectively. Metallo-\u03b2-lactamase genes were detected among 4.3% of the isolates from 2007 to 2009 and 12.7% of the isolates from 2014 to 2016, mainly due to the dissemination of isolates carrying blaNDM. Genes encoding IMP and VIM enzymes were observed in 1.9% and 2.4% (7 and 9 isolates) of the isolates from 2007 to 2009 and 0.4% and 1.9% of the isolates from 2014 to 2016. OXA-48 and variants increased from 4.3% in 2007\u20132009 to 12.6% in 2014\u20132016 (mainly in Europe).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A change in the epidemiology of carbapenemases and important increases in ESBL, CRE, MDR, and other resistant phenotypes among virtually all geographic regions and infection sources were noted in the 20 years of surveillance, highlighting the impact of antimicrobial resistance and the importance of its continuous monitoring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofy347","type":"journal-article","created":{"date-parts":[[2019,3,16]],"date-time":"2019-03-16T03:21:58Z","timestamp":1552706518000},"page":"S23-S33","source":"Crossref","is-referenced-by-count":163,"title":["Variations in the Occurrence of Resistance Phenotypes and Carbapenemase Genes Among Enterobacteriaceae Isolates in 20 Years of the SENTRY Antimicrobial Surveillance Program"],"prefix":"10.1093","volume":"6","author":[{"given":"Mariana","family":"Castanheira","sequence":"first","affiliation":[{"name":"JMI Laboratories, North Liberty, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalitagauri M","family":"Deshpande","sequence":"additional","affiliation":[{"name":"JMI Laboratories, North Liberty, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo E","family":"Mendes","sequence":"additional","affiliation":[{"name":"JMI Laboratories, North Liberty, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Canton","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helio S","family":"Sader","sequence":"additional","affiliation":[{"name":"JMI Laboratories, North Liberty, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald N","family":"Jones","sequence":"additional","affiliation":[{"name":"JMI Laboratories, North Liberty, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,15]]},"reference":[{"key":"2020081004074143400_CIT0001","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1586\/14787210.6.5.671","article-title":"Clinical significance of extended-spectrum beta-lactamases","volume":"6","author":"Rodr\u00edguez-Ba\u00f1o","year":"2008","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2020081004074143400_CIT0002","doi-asserted-by":"crossref","first-page":"e00079","DOI":"10.1128\/CMR.00079-17","article-title":"Treatment of infections caused by extended-spectrum-beta-lactamase-, AmpC-, and carbapenemase-producing Enterobacteriaceae","volume":"31","author":"Rodriguez-Bano","year":"2018","journal-title":"Clin Microbiol Rev"},{"key":"2020081004074143400_CIT0003","first-page":"49","article-title":"Clinical management of infections caused by multidrug-resistant Enterobacteriaceae","volume":"1","author":"Delgado-Valverde","year":"2013","journal-title":"Ther Adv Infect Dis"},{"key":"2020081004074143400_CIT0004","volume-title":"Antimicrobial Resistance Surveillance in Europe: Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net), 2009","author":"ECDC","year":"2010"},{"key":"2020081004074143400_CIT0005","volume-title":"Surveillance of Antimicrobial Resistance in Europe: Annual","author":"ECDC","year":"2017"},{"key":"2020081004074143400_CIT0006","doi-asserted-by":"crossref","first-page":"313","DOI":"10.2165\/11533040-000000000-00000","article-title":"Infections with extended-spectrum beta-lactamase-producing Enterobacteriaceae: changing epidemiology and drug treatment choices","volume":"70","author":"Pitout","year":"2010","journal-title":"Drugs"},{"key":"2020081004074143400_CIT0007","volume-title":"M100Ed28E. 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