{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:37:10Z","timestamp":1774438630670,"version":"3.50.1"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"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":[[2016,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The increasing use of carbapenems for treating multidrug-resistant (MDR) Gram-negative bacterial infections has contributed to the global dissemination of carbapenem-resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Enterobacteriaceae<\/jats:named-content>\n            (CRE). Serine and metallo-\u03b2-lactamases (MBLs) that hydrolyze carbapenems have become prevalent and endemic in some countries, necessitating the use of older classes of agents, such as colistin. A total of 19,719 isolates 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            (excluding\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Proteeae<\/jats:named-content>\n            and\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Serratia<\/jats:named-content>\n            spp., which have innate resistance to colistin) were collected from infected patients during 2012 and 2013 in a global surveillance program and tested for antimicrobial susceptibility using CLSI methods. Isolates of CRE were characterized for carbapenemases and extended-spectrum \u03b2-lactamases (ESBLs) by PCR and sequencing. Using EUCAST breakpoints, the rate of colistin susceptibility was 98.4% overall, but it was reduced to 88.0% among 482 carbapenemase-positive isolates. Colistin susceptibility was higher among MBL-positive isolates (92.6%) than those positive for a KPC (87.9%) or OXA-48 (84.2%). Of the agents tested, only tigecycline (MIC\n            <jats:sub>90<\/jats:sub>\n            , 2 to 4 \u03bcg\/ml) and aztreonam-avibactam (MIC\n            <jats:sub>90<\/jats:sub>\n            , 0.5 to 1 \u03bcg\/ml) consistently tested with low MIC values against colistin-resistant, ESBL-positive, and carbapenemase-positive isolates. Among the 309 (1.6%) colistin-resistant isolates from 10 species collected in 38 countries, 58 carried a carbapenemase that included KPCs (38 isolates), MBLs (6 isolates), and OXA-48 (12 isolates). These isolates were distributed globally (16 countries), and 95% were\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            . Thirty-nine (67.2%) isolates carried additional ESBL variants of CTX-M, SHV, and VEB. This sample 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            demonstrated a low prevalence of colistin resistance overall. However, the wide geographic dispersion of colistin resistance within diverse genus and species groups and the higher incidence observed among carbapenemase-producing MDR pathogens are concerning.\n          <\/jats:p>","DOI":"10.1128\/aac.01870-15","type":"journal-article","created":{"date-parts":[[2015,12,15]],"date-time":"2015-12-15T04:43:50Z","timestamp":1450154630000},"page":"1385-1392","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":84,"title":["Correlation of \u03b2-Lactamase Production and Colistin Resistance among Enterobacteriaceae Isolates from a Global Surveillance Program"],"prefix":"10.1128","volume":"60","author":[{"given":"Patricia A.","family":"Bradford","sequence":"first","affiliation":[{"name":"AstraZeneca Pharmaceuticals, Waltham, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystyna M.","family":"Kazmierczak","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas J.","family":"Biedenbach","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.","family":"Wise","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith","family":"Hackel","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel F.","family":"Sahm","sequence":"additional","affiliation":[{"name":"International Health Management Associates, Inc., Schaumburg, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2012.11.009"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1710.110655"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.11.49"},{"key":"e_1_3_3_5_2","first-page":"8","article-title":"The growing resistance of Klebsiella pneumoniae; the need to expand our antibiogram: case report and review of the literature","volume":"7","author":"Garbati MA","year":"2013","unstructured":"Garbati MA, Al Godhair AI. 2013. 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