{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:37Z","timestamp":1787013877785,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study aims to evaluate the activity of Cefepime\/enmetazobactam (FEP\/META) in a Regional Hospital in southern Spain, against a collection of ESBL\u2010producing Enterobacteriaceae with or without carbapenemases, comparing it with piperacillin\/tazobactam (PIP\/TAZ) and meropenem (MER). A total of 150 ESBL\u2010, KPC\u2010, and OXA\u201048\u2010producing strains were selected, excluding those producing metallo\u2010\u03b2\u2010lactamases. Of these isolates, 117 (78%) were from urine cultures and 33 (22%) from rectal colonization surveillance cultures. Isolates were collected between January 1, 2022, and June 30, 2024. Overall, 23% of ESBL\u2010producers were resistant to PIP\/TAZ. Similarly, 30% of OXA\u201048 producers were resistant to PIP\/TAZ. FEP\/META was the most active agent (7.1% of resistance) against ESBL and OXA\u201048 producers' strains. KPC\u2010producers were all resistant to PIP\/TAZ and FEP\/META, while 66.7% were resistant to MER. Considering the total group of \u03b2\u2010lactamase\u2010producing bacteria, 48.67% were resistant to PIP\/TAZ, compared to 6.67% to MER and 4.67% to FEP\/META (\n                    <jats:italic>p<\/jats:italic>\n                    value &lt;\u20090.0001). Pairwise comparisons showed significant differences between FEP\/META and PIP\/TAZ, as well as between PIP\/TAZ and MER (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). FEP\/META represents a promising therapeutic option for the treatment of infections caused by Gram\u2010negative bacteria resistant to third\u2010generation cephalosporins. It could also be an alternative to OXA\u201048 carbapenemase\u2010producing Enterobacteriaceae.\n                  <\/jats:p>","DOI":"10.1111\/apm.70146","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T08:45:16Z","timestamp":1768985116000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cefepime\/Enmetazobactam as a Carbapenem\u2010Sparing Alternative: Activity Against Extended\u2010Spectrum \u03b2\u2010Lactamase\u2010Producing Enterobacteria With and Without Carbapenemases in Southern Spain"],"prefix":"10.1111","volume":"134","author":[{"given":"Leticia","family":"Castellano\u2010S\u00e1nchez","sequence":"first","affiliation":[{"name":"Microbiology Laboratory Hospital Universitario Virgen de las Nieves\u2010Instituto de Investigaci\u00f3n Biosanitaria de Granada  Granada Spain"},{"name":"Clinical Medicine and Public Health Doctoral Program, Graduate School University of Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Aguilera\u2010Franco","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory Hospital Universitario Virgen de las Nieves\u2010Instituto de Investigaci\u00f3n Biosanitaria de Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Albend\u00edn\u2010Moreno","sequence":"additional","affiliation":[{"name":"Department of Microbiology School of Medicine, University of Granada\u2010Instituto de Investigaci\u00f3n Biosanitaria de Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Carmen","family":"Olvera\u2010Porcel","sequence":"additional","affiliation":[{"name":"Biostatistics, Unidad de Gesti\u00f3n y Apoyo a la Investigaci\u00f3n Hospital Universitario Virgen de las Nieves  Granada 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Granada  Granada Spain"},{"name":"Clinical Medicine and Public Health Doctoral Program, Graduate School University of Granada  Granada Spain"},{"name":"Department of Internal Medicine Hospital Universitario Virgen de las Nieves\u2010Instituto de Investigaci\u00f3n Biosanitaria de Granada  Granada 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