{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:05:28Z","timestamp":1791475528203,"version":"4.3.4"},"reference-count":106,"publisher":"Akademiai Kiado Zrt.","issue":"2","content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMICR"],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The present study aimed to evaluate the\n                    <jats:italic>in vitro<\/jats:italic>\n                    activity of ceftazidime\u2013avibactam (CZA), imipenem\u2013cilastatin\u2013relebactam (IMR), meropenem\u2013vaborbactam (MEV), cefiderocol (CFDC), and plazomicin (PLZ), against nosocomial carbapenem-resistant\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    (CRPA) (\n                    <jats:italic>n<\/jats:italic>\n                    = 40), carbapenem-resistant\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    (CRAB) (\n                    <jats:italic>n<\/jats:italic>\n                    = 56), and\n                    <jats:italic>Stenotrophomonas maltophilia<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 50) isolates from Bulgaria (2014\u20132023). Antimicrobial susceptibility testing, polymerase chain reaction screening for antimicrobial resistance (AMR) determinants, and whole-genome sequencing were performed. In CRPA,\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    (20%)\n                    <jats:sub>,<\/jats:sub>\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>VIM-2<\/jats:sub>\n                    (5%)\n                    <jats:sub>,<\/jats:sub>\n                    and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>VIM-4<\/jats:sub>\n                    (2.5%) metallo-\u03b2-lactamase (MBL)-encoding genes were detected. Both\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    and\n                    <jats:italic>S. maltophilia<\/jats:italic>\n                    showed absolute susceptibility to CFDC, and 78.6% of the tested\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    isolates were also susceptible. All CFDC-resistant (MIC values in the range of 4\u201364\u2009mg L\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) CRAB isolates (12 out of 56) were positive for\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>PER-1<\/jats:sub>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 12) and acquired class D carbapenemase genes, as follows:\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA-23-like<\/jats:sub>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 7),\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA-24\/40-like<\/jats:sub>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 1), and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA-23-like<\/jats:sub>\n                    +\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA-24\/40-like<\/jats:sub>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 4). Only 22.5\u201325% of CRPA isolates revealed susceptibility to the combined \u03b2-lactam (BL)\u2013\u03b2-lactamase inhibitor (BLI) antimicrobials. Equal PLZ MIC\n                    <jats:sub>50<\/jats:sub>\n                    values were reported against\n                    <jats:italic>P.\u00a0aeruginosa<\/jats:italic>\n                    \u00a0and\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    (8\u2009mg L\n                    <jats:sup>\u22121<\/jats:sup>\n                    ), but higher MIC\n                    <jats:sub>90<\/jats:sub>\n                    values against CRAB (&gt;256 vs. 16\u2009mg L\n                    <jats:sup>\u22121<\/jats:sup>\n                    ). MBL-producing CRPA demonstrated absolute resistance to all BL\u2013BLI preparations, whereas non-MBL-producing isolates possessed significantly higher susceptibility (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.05), ranging from 31% (for CZA and IMR) to 34.5% (MEV). In conclusion, the emergence of MBL-positive\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    and the associated ineffectiveness of the novel BL\u2013BLI combinations, as well as the relatively high proportion of\u00a0CFDC-resistant\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    isolates, are alarming. Therefore, continuous surveillance of AMR concerning newly approved antibiotics should be the mainstay of multifaceted global and national \u201cOne\u00a0Health\u201d strategies and infection control stewardship practices in hospital settings.\n                  <\/jats:p>","DOI":"10.1556\/030.2026.02958","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:09:52Z","timestamp":1777280992000},"page":"157-167","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["In vitro activity of ceftazidime\u2013avibactam, imipenem\u2013cilastatin\u2013relebactam, meropenem\u2013vaborbactam, cefiderocol, and plazomicin against non-fermenting Gram-negative isolates obtained from Bulgarian inpatients"],"prefix":"10.1556","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5197-1849","authenticated-orcid":true,"given":"Tanya","family":"Strateva","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology \u201cCorr. 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