{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:07:57Z","timestamp":1777932477393,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>\n                    Carbapenem-resistant gram-negative organisms are a rising global concern, and novel therapeutic options are urgently needed. Cefepime\/enmetazobactam (FEP\/META), approved for the treatment of complicated urinary tract infections, could be an important asset in clinical care. This study aimed to determine the activity of FEP\/META in a collection of genetically characterized carbapenem-resistant Enterobacterales and\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    . FEP\/META susceptibility was tested in 104 carbapenem-resistant clinical isolates (\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    , 14;\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    , 30; other Enterobacterales [oEs]), 29;\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    , 31) as tested by agar disk diffusion according to the European Committee on Antimicrobial Susceptibility Testing protocols. A carbapenemase gene was identified in 75% (78\/104) of all isolates. A cefepime-resistant phenotype was detected in 89% (93\/104) of all isolates. FEP\/META was active against 29% (30\/104) of all isolates tested, including 2\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    , 5\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    , 11 oEs, and 12\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    isolates. Twenty-two out of 78 (28%) of all carbapenemase-positive and 8 out of 26 (31%) of all carbapenemase-negative isolates were tested susceptible to FEP\/META, respectively. META restored FEP susceptibility in 22\/93 (24%) of cefepime-resistant isolates (16 carbapenemase-positive, 6 carbapenemase-negative), indicating a direct META effect to restore cefepime susceptibility. In conclusion, this study provides evidence for activity of FEP\/META in selected carbapenem-resistant Enterobacterales and\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    . Susceptibility varied across resistance genotypes and included isolates carrying resistance determinants formally not targeted by META. FEP\/META could be an option for carbapenem-resistant organisms if other recommended therapies fail.\n                  <\/jats:p>","DOI":"10.1177\/10766294261431287","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:57:02Z","timestamp":1774263422000},"page":"182-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Activity of Cefepime\/Enmetazobactam in Carbapenem-Resistant Gram-Negative Bacteria: Real-World Evidence from a German Tertiary Care Center"],"prefix":"10.1177","volume":"32","author":[{"given":"Patricia","family":"Bartsch","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samira","family":"Wei\u00dfelberg","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luise","family":"Brakert","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Savickis","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Haffke","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Aepfelbacher","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8587-4433","authenticated-orcid":false,"given":"Holger","family":"Rohde","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Mikrobiologie, Virologie und Hygiene, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(24)01867-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-019-01180-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00047-19"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.50.2200926"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(25)00118-5"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00180-20"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02345-24"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2024.2427310"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens14040307"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2024.09.031"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/17460913.2025.2468112"},{"key":"e_1_3_3_13_2","unstructured":"(EUCAST) ECoAST. 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