{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T13:15:46Z","timestamp":1779282946712,"version":"3.51.4"},"reference-count":24,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The NG-test CARBA 5 and Xpert Carba-R IVD kits were tested against 269 clinical Enterobacterales isolates selected for their previously determined carbapenemase content from the ATLAS Global Surveillance program, primarily from 2020 to 2022. Antimicrobial susceptibility testing by broth microdilution was performed for aztreonam-avibactam, cefiderocol, and othe agents using EUCAST 2025 breakpoints for interpretation. The CARBA 5 and Carba-R IVD kits accurately identified all NDM (93), KPC (36), and OXA-48-like (43) carbapenemases. The CARBA 5 detected all IMP (42) and 45\/47 VIM, and the Carba-R detected all VIM (47) and 21\/42 IMP. Aztreonam-avibactam was active against carbapenemase-producing isolates (percent susceptible [carbapenemases]): 90.7% (NDM), 92.9% (NDM+OXA-48-like), 100% (IMP, VIM, and KPC), and 88.9% (OXA-48-like). Cefiderocol susceptibility was as follows: 38.7% (NDM), 50.0% (NDM+OXA-48-like), 77.5% (IMP), 82.5% (VIM), 75.9% (KPC), and 100% (OXA-48-like). The most common carbapenemases in Enterobacterales include NDM, KPC, and OXA-48-like enzymes, all of which were accurately identified by the CARBA 5 and Carba-R kits. Aztreonam-avibactam demonstrated potent\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      activity against isolates determined to be positive for carbapenemases by these kits, offering a potential therapeutic option when one of these isolates is encountered in the clinic.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">In vitro<\/jats:italic>\n                        diagnostic (IVD) kits exist that detect carbapenemases in clinical isolates of Enterobacterales. Their utility is hampered by the limited options to reliably treat infections caused by Enterobacterales that produce metallo-\u03b2-lactamases. Here, we test the utility of IVD kits for detecting carbapenemases in a recent collection of clinical Enterobacterales isolates and determine the\n                        <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                        activity of aztreonam-avibactam, cefiderocol, and other comparator agents against isolates that were positive for carbapenemases.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.03820-25","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T15:20:57Z","timestamp":1774970457000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["The\n                    <i>in vitro<\/i>\n                    activity of aztreonam-avibactam and cefiderocol against globally collected clinical metallo-\u03b2-lactamase- and\/or serine-carbapenemase-positive Enterobacterales isolates and the utility of commonly used\n                    <i>in vitro<\/i>\n                    diagnostic kits"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3941-6589","authenticated-orcid":true,"given":"Mark","family":"Estabrook","sequence":"first","affiliation":[{"name":"IHMA","place":["Schaumburg, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Streit","sequence":"additional","affiliation":[{"name":"IHMA","place":["Schaumburg, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Townsend","sequence":"additional","affiliation":[{"name":"Pfizer Inc","place":["Tadworth, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Stone","sequence":"additional","affiliation":[{"name":"Pfizer Inc","place":["Groton, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shweta","family":"Kamat","sequence":"additional","affiliation":[{"name":"Pfizer PIPL","place":["Mumbai, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Sahm","sequence":"additional","affiliation":[{"name":"IHMA","place":["Schaumburg, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases13020059"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.296"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01406-22"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2024.03.020"},{"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":"10.1186\/s12866-021-02309-9"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2013.01.005"},{"key":"e_1_3_4_9_2","unstructured":"European Medicines Agency. 2025. An overview of Emblaveo and why it is authorised in the EU. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/overview\/emblaveo-epar-medicine-overview_en.pdf"},{"key":"e_1_3_4_10_2","unstructured":"AbbVie. 2025 U.S. FDA Approves EMBLAVEO (aztreonam and avibactam) for the treatment of adults with complicated intra-abdominal infections with limited or no treatment options. Available from: https:\/\/news.abbvie.com\/2025-02-07-U-S-FDA-Approves-EMBLAVEO-TM-aztreonam-and-avibactam-for-the-Treatment-of-Adults-With-Complicated-Intra-Abdominal-Infections-With-Limited-or-No-Treatment-Options"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2022.06.018"},{"key":"e_1_3_4_12_2","unstructured":"European Medicines Agency. 2025. An overview of Fetcroja and why it is authorised in the EU. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/overview\/fetcroja-epar-medicine-overview_en.pdf"},{"key":"e_1_3_4_13_2","unstructured":"Shionogi & Co. Ltd. 2024. Fetroja (Cefiderocol) prescribing information. Available from: https:\/\/www.shionogi.com\/content\/dam\/shionogi\/si\/products\/pdf\/fetroja.pdf"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01405-16"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlaa060"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/Spectrum.01779-21"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05186-14"},{"key":"e_1_3_4_18_2","volume-title":"CLSI standard M07","author":"CLSI","year":"2024","unstructured":"CLSI. 2024. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. In CLSI standard M07, 12th ed. Clinical and Laboratory Standards Institute.","edition":"12"},{"key":"e_1_3_4_19_2","unstructured":"The European Committee on Antimicrobial Susceptibility Testing. 2025. Breakpoint tables for interpretation of MICs and zone diameters. https:\/\/www.eucast.org."},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2023.106776"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2021.01.010"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/labmed\/lmaa084"},{"key":"e_1_3_4_23_2","unstructured":"Cepheid. 2020. Xpert Carba-R GXCARBAR-10. Available from: https:\/\/www.cepheid.com\/content\/dam\/www-cepheid-com\/documents\/package-insert-files\/Xpert-Carba-R-Rx-Only-US-IVD-ENGLISH-Package-Insert-301-2438-Rev-G.pdf"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2019.00162"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.01728-21"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.03820-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.03820-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T13:04:56Z","timestamp":1779282296000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.03820-25"}},"subtitle":[],"editor":[{"given":"Pablo","family":"Power","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,5]]}},"alternative-id":["10.1128\/spectrum.03820-25"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.03820-25","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"assertion":[{"value":"2025-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e03820-25"}}