{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:28:10Z","timestamp":1790659690159,"version":"4.1.0"},"reference-count":44,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Klebsiella pneumoniae<\/jats:named-content>\n            carbapenemase (KPC), first described in the United States in 1996, is now a widespread global problem in several Gram-negative species. A worldwide surveillance study collected Gram-negative pathogens from 202 global sites in 40 countries during 2012 to 2014 and determined susceptibility to \u03b2-lactams and other class agents by broth microdilution testing. Molecular mechanisms of \u03b2-lactam resistance among carbapenem-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Enterobacteriaceae<\/jats:named-content>\n            and\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Pseudomonas aeruginosa<\/jats:named-content>\n            were determined using PCR and sequencing. Genes encoding KPC enzymes were found in 586 isolates from 22 countries (76 medical centers), including countries in the Asia-Pacific region (32 isolates), Europe (264 isolates), Latin America (210 isolates), and the Middle East (19 isolates, Israel only) and the United States (61 isolates). The majority of isolates were\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">K. pneumoniae<\/jats:named-content>\n            (83.4%); however, KPC was detected in 13 additional species. KPC-2 (69.6%) was more common than KPC-3 (29.5%), with regional variation observed. A novel KPC variant, KPC-18 (KPC-3[V8I]), was identified during the study. Few antimicrobial agents tested remained effective\n            <jats:italic>in vitro<\/jats:italic>\n            against KPC-producing isolates, with ceftazidime-avibactam (MIC\n            <jats:sub>90<\/jats:sub>\n            , 4 \u03bcg\/ml), aztreonam-avibactam (MIC\n            <jats:sub>90<\/jats:sub>\n            , 0.5 \u03bcg\/ml), and tigecycline (MIC\n            <jats:sub>90<\/jats:sub>\n            , 2 \u03bcg\/ml) retaining the greatest activity against\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Enterobacteriaceae<\/jats:named-content>\n            cocarrying KPC and other \u03b2-lactamases, whereas colistin (MIC\n            <jats:sub>90<\/jats:sub>\n            , 2 \u03bcg\/ml) demonstrated the greatest\n            <jats:italic>in vitro<\/jats:italic>\n            activity against KPC-positive\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. aeruginosa<\/jats:named-content>\n            . This analysis of surveillance data demonstrated that KPC is widely disseminated. KPC was found in multiple species of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Enterobacteriaceae<\/jats:named-content>\n            and\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. aeruginosa<\/jats:named-content>\n            and has now become a global problem.\n          <\/jats:p>","DOI":"10.1128\/aac.00107-16","type":"journal-article","created":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T03:05:16Z","timestamp":1462849516000},"page":"4490-4500","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":102,"title":["Global Dissemination of\n            <i>bla<\/i>\n            <sub>KPC<\/sub>\n            into Bacterial Species beyond Klebsiella pneumoniae and\n            <i>In Vitro<\/i>\n            Susceptibility to Ceftazidime-Avibactam and Aztreonam-Avibactam"],"prefix":"10.1128","volume":"60","author":[{"given":"Krystyna M.","family":"Kazmierczak","sequence":"first","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Biedenbach","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Hackel","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Rabine","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boudewijn L. M.","family":"de Jonge","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Waltham, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel K.","family":"Bouchillon","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F.","family":"Sahm","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Bradford","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Waltham, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2007.121004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir202"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2012.03821.x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.05035-11"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2013.11.007"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.2012.681369"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70190-7"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-0711-11-32"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01222-13"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12697"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.4.1151-1161.2001"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70054-4"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01019-15"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00204-11"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt094"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tim.2014.09.003"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.04903-14"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/genomeA.00659-15"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.03926-14"},{"key":"e_1_3_3_21_2","volume-title":"CLSI document M07-A9","author":"Clinical and Laboratory Standards Institute","year":"2012","unstructured":"Clinical and Laboratory Standards Institute. 2012. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard, 9th ed. CLSI document M07-A9. Clinical and Laboratory Standards Institute, Wayne, PA, USA.","edition":"9"},{"key":"e_1_3_3_22_2","volume-title":"CLSI document M100-S25","author":"Clinical and Laboratory Standards Institute","year":"2015","unstructured":"Clinical and Laboratory Standards Institute. 2015. Performance standards for antimicrobial susceptibility testing; 25th informational supplement. CLSI document M100-S25. Clinical and Laboratory Standards Institute, Wayne, PA, USA."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05186-14"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05065-14"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00693-09"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00008-10"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00334-12"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.12.4793-4799.2004"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.012575-0"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05100-14"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2015.04.002"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00899-09"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks443"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02423-13"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05202-11"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1086\/648077"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0133727"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00116-14"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00099-14"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1321364111"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1086\/588048"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit500"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofv050"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00655-15"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01165-15"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00107-16","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00107-16","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T20:57:41Z","timestamp":1645477061000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.00107-16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":44,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1128\/AAC.00107-16"],"URL":"https:\/\/doi.org\/10.1128\/aac.00107-16","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8]]},"assertion":[{"value":"2016-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}