{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:59:26Z","timestamp":1792004366628,"version":"4.4.0"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["24-PZR-03"],"award-info":[{"award-number":["24-PZR-03"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["various"],"award-info":[{"award-number":["various"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      We evaluated the activity of aztreonam-avibactam and comparators tested against 490 MBL-producing Enterobacterales isolates collected in 27 countries during 2019\u20132022. The most common MBL was NDM-1, which was detected among 307 isolates. The genes encoding NDM-5 and VIM-1 were detected among 68 and 53 isolates, respectively. Other 14 MBL-encoding genes or combinations were detected among 62 isolates. Mexico, Turkey, and Greece had the highest number of isolates (60, 59, and 57, respectively). All isolates were susceptible to aztreonam-avibactam (MIC\n                      <jats:sub>50\/90<\/jats:sub>\n                      , 0.12\/0.5 mg\/L) when applying the EUCAST or FDA recently approved breakpoints (\u22644 mg\/L susceptible). Cefiderocol inhibited 66.7%\/90.8% of the isolates when using EUCAST\/FDA breakpoints. Cefepime-taniborbactam was active against 36.7%\/55.5% of the isolates using the cefepime breakpoint for comparison purposes. Tigecycline and colistin inhibited 94.1% and 76.6% of the isolates (FDA and EUCAST breakpoints, respectively). The analysis of resistance mechanisms and genetic background of the MBL-producing isolates demonstrated genetic diversity among main species and presence of multiple resistance mechanisms including other \u03b2-lactamases, porin changes, and disruptions of efflux pump repressors. Aztreonam-avibactam was active despite the presence of these additional resistance mechanisms, but cefiderocol and cefepime-taniborbactam displayed variable activity. PBP3 YRIN and YRIK insertions were observed among 30 MBL-producing\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      isolates. Aztreonam-avibactam MIC values ranged from 0.03 to 4 mg\/L for these isolates, including an isolate carrying\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-7<\/jats:sub>\n                      ,\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CMY-42<\/jats:sub>\n                      , and porin changes. MBL-producing organisms are still considered an unmet medical need. Aztreonam-avibactam was active against this large collection of MBL-producing isolates that had elevated MIC values for many comparator agents.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00842-25","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T11:03:44Z","timestamp":1764932624000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":14,"title":["Activity of aztreonam-avibactam, cefiderocol, and cefepime-taniborbactam against a global collection of genetically characterized metallo-\u03b2-lactamase-producing Enterobacterales"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-1782","authenticated-orcid":true,"given":"Mariana","family":"Castanheira","sequence":"first","affiliation":[{"name":"Element Materials Technology (JMI Laboratories)","place":["North Liberty, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0457-1543","authenticated-orcid":true,"given":"John H.","family":"Kimbrough","sequence":"additional","affiliation":[{"name":"Element Materials Technology (JMI Laboratories)","place":["North Liberty, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina M.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Element Materials Technology (JMI Laboratories)","place":["North Liberty, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Karr","sequence":"additional","affiliation":[{"name":"Element Materials Technology (JMI Laboratories)","place":["North Liberty, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7022-6644","authenticated-orcid":true,"given":"Helio S.","family":"Sader","sequence":"additional","affiliation":[{"name":"Element Materials Technology (JMI Laboratories)","place":["North Liberty, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.38.1.71"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.7.1584"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00047-19"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy347"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00774-09"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq179"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30868-9"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmb.2019.04.002"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2012.06796.x"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01510-23"},{"key":"e_1_3_4_12_2","unstructured":"European Medicines Agency. 2024. 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Available from: https:\/\/www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/Breakpoint_tables\/v_14.0_Breakpoint_Tables.pdf"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-10-421"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-11756-y"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00069-5"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-024-02082-9"},{"key":"e_1_3_4_22_2","unstructured":"European Center for Disease Prevention and Control. 2025. Increase in carbapenem-resistant Enterobacterales (CRE) poses a significant threat to patients and healthcare systems in the EU\/EEA. Available from: https:\/\/www.ecdc.europa.eu\/en\/news-events\/increase-carbapenem-resistant-enterobacterales-cre-poses-significant-threat-patients"},{"key":"e_1_3_4_23_2","unstructured":"CDC. 2024. Carbapenem-resistant Enterobacterales (CRE): an urgetn public health threat. Available from: https:\/\/arpsp.cdc.gov\/story\/cre-urgent-public-health-threat#:~:text=CRE%20can%20cause%20infections%20when caused%20by%20injury%20or%20surgery"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-021-04296-1"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00397-20"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-025-05266-1"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13111045"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad725"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2022.0260"},{"key":"e_1_3_4_30_2","unstructured":"FDA. 2015. Drug approval package AVYCAZ (ceftazidime-avibactam) injection. 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