{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:13:08Z","timestamp":1791825188590,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T00:00:00Z","timestamp":1607040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Infections caused by carbapenemase\u2010producing<jats:italic>Enterobacteriaceae<\/jats:italic>(CPE) are an emerging threat in both solid organ and stem cell transplant recipients. Invasive CPE infections in transplant recipients are associated with a high mortality, often due to limited therapeutic options and antibacterial toxicities. One of the most therapeutically challenging group of CPE are the metallo\u2010\u03b2\u2010lactamase (MBL)\u2010producing Gram\u2010negative bacteria, which are now found worldwide, and often need treatment with older, highly toxic antimicrobial regimens. Newer \u03b2\u2010lactamase inhibitors such as avibactam have well\u2010established activity against certain carbapenemases such as<jats:italic>Klebsiella pneumoniae<\/jats:italic>carbapenemases (KPC), but have no activity against MBL\u2010producing organisms. Conversely, aztreonam has activity against MBL\u2010producing organisms but is often inactivated by other co\u2010existing \u03b2\u2010lactamases. Here, we report four cases of invasive MBL\u2010CPE infections in transplant recipients caused by IMP\u20104\u2010producing<jats:italic>Enterobacter cloacae<\/jats:italic>who were successfully treated with a new, mechanism\u2010driven antimicrobial combination of ceftazidime\/avibactam with aztreonam. This novel antimicrobial combination offers a useful treatment option for high\u2010risk patients with CPE infection, with reduced drug interactions and toxicity.<\/jats:p>","DOI":"10.1111\/tid.13510","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T04:03:50Z","timestamp":1605931430000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Treatment of invasive IMP\u20104<i>Enterobacter cloacae<\/i>infection in transplant recipients using ceftazidime\/avibactam with aztreonam: A case series and literature review"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-3972","authenticated-orcid":false,"given":"Kelly A.","family":"Cairns","sequence":"first","affiliation":[{"name":"Pharmacy Department Alfred Health Melbourne Vic. 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9249-1780","authenticated-orcid":false,"given":"David W.J.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Alfred and Central Clinical School Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1774-8619","authenticated-orcid":false,"given":"James D.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Alfred and Central Clinical School Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-7423","authenticated-orcid":false,"given":"Sadid F.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Alfred and Central Clinical School Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6590-6127","authenticated-orcid":false,"given":"Iain J.","family":"Abbott","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Alfred and Central Clinical School Monash University Melbourne Vic. 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Love","sequence":"additional","affiliation":[{"name":"Renal Medicine Alfred Health Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela E.","family":"Corallo","sequence":"additional","affiliation":[{"name":"Pharmacy Department Alfred Health Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bergin","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplantation Unit The Alfred Hospital Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4205-1098","authenticated-orcid":false,"given":"Ashish","family":"Sharma","sequence":"additional","affiliation":[{"name":"Renal Medicine Alfred Health Melbourne Vic. 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