{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:29:28Z","timestamp":1780568968209,"version":"3.54.1"},"reference-count":40,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"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":[[2024,12,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Carbapenem-resistant\n              <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n              (CRPA) are of major clinical concern. We analyzed 85\n              <jats:italic>P<\/jats:italic>\n              .\n              <jats:italic>aeruginosa<\/jats:italic>\n              blood isolates non-susceptible to carbapenems collected during 2021\u20132023 from 15 medical centers in Israel. We aimed to determine the prevalence of high-risk clones, examine clonality, test antibiotic susceptibility, and assess the presence of acquired resistance genes, including carbapenemases. Whole-genome sequencing was performed using Illumina sequencing technology. Susceptibly was determined using the broth microdilution method. In the entire sample, 43.5% were high-risk clones. A main clade (27.1% of isolates) found in multiple hospitals comprised 19 isolates belonging to the high-risk ST654 clone and four closely related isolates. The isolates in this main clade harbored a broad set of resistance genes, including GES-type genes, and 91% had a mutated outer membrane protein (OprD). Isolates in the main clade were uniformly tobramycin (TOB) resistant and 83% were ceftolozane\/tazobactam resistant. In the entire sample, we found high resistance to most antipseudomonal agents, including new beta-lactam\/beta-lactamase inhibitor combinations. No uniform susceptibility to an antipseudomonal agent was found. Carbapenemases were carried by 9.4% of isolates (5.9%\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>GES-5<\/jats:sub>\n              and 3.5%\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>NDM-1<\/jats:sub>\n              ) and\n              <jats:italic>oprD<\/jats:italic>\n              was mutated in 67% of isolates. Thus, the epidemiology of CRPA is explained by a combination of clonal expansion of a dominant high-risk clade and sporadic occurrence of mutated strains. Our findings highlight the importance of susceptibility testing using a wide panel of antibiotics when CRPA is detected. Prevention measures tracking and controlling emerging high-risk clades and clones are crucial to limit the spread of CRPA.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.00965-24","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T13:00:28Z","timestamp":1730379628000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["<i>bla<\/i>\n            <sub>GES<\/sub>\n            -producing ST654 comprises a quarter of all carbapenem-resistant\n            <i>Pseudomonas aeruginosa<\/i>\n            in blood isolates from 15 hospitals"],"prefix":"10.1128","volume":"68","author":[{"given":"Hadas","family":"Kon","sequence":"first","affiliation":[{"name":"National Institute for Antibiotic Resistance and Infection Control, Ministry of Health","place":["Tel Aviv, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mor 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