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All isolates belonged to clone ST253 and exhibited difficult-to-treat resistance, including resistance to imipenem\/relebactam and meropenem\/vaborbactam. Genomic analysis confirmed a plasmid-encoded\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      and OprD deficiency. Functional assays demonstrated synergy between KPC-2 production and porin loss on resistance to carbapenem\/\u03b2-lactamase inhibitors. The findings highlight the clinical threat posed by KPC-producing\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01657-25","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:10:57Z","timestamp":1774620657000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Emergence of KPC-producing\n                    <i>Pseudomonas aeruginosa<\/i>\n                    in Spain: insights into an outbreak and resistance to the novel carbapenem\/\u03b2-lactamase inhibitor combinations imipenem\/relebactam and meropenem\/vaborbactam"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8039-6641","authenticated-orcid":true,"given":"Gloria","family":"P\u00e9rez-Rodr\u00edguez","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qckj285","id-type":"ROR","asserted-by":"publisher"}],"name":"Servicio de Microbiolog\u00eda Cl\u00ednica and Grupo de Investigaci\u00f3n en Microbiolog\u00eda, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Complexo Hospitalario Universitario de A Coru\u00f1a (CHUAC), SERGAS, Universidade da Coru\u00f1a (UDC)","place":["A Coru\u00f1a, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6296-5949","authenticated-orcid":true,"given":"Pablo","family":"Aja-Macaya","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qckj285","id-type":"ROR","asserted-by":"publisher"}],"name":"Servicio de Microbiolog\u00eda Cl\u00ednica and 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