{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:37:09Z","timestamp":1792640229128,"version":"4.5.0"},"reference-count":28,"publisher":"Centers for Disease Control and Prevention (CDC)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emerg. Infect. Dis."],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.3201\/eid3206.260478","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T19:28:47Z","timestamp":1778268527000},"source":"Crossref","is-referenced-by-count":5,"title":["Emergence of\n                    <i>Klebsiella pneumoniae<\/i>\n                    Carbapenemase\u2013Producing\n                    <i>K. pneumoniae<\/i>\n                    with Penicillin-Binding Protein 3 Insertions, Taiwan, 2021"],"prefix":"10.3201","volume":"32","author":[{"given":"Tengfei","family":"Long","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianne","family":"Lovey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillie","family":"Sanborn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zackery P.","family":"Bulman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Tsung","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1822","reference":[{"key":"key-10.3201\/eid3206.260478-202605081528-R1","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1016\/S1473-3099(25)00118-5","article-title":"The WHO bacterial priority pathogens list 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance.","volume":"25","author":"Sati","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R2","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.7326\/ANNALS-25-02404","article-title":"Changes in carbapenemase-producing carbapenem-resistant Enterobacterales, 2019 to 2023.","volume":"178","author":"Rankin","year":"2025","journal-title":"Ann Intern Med"},{"key":"key-10.3201\/eid3206.260478-202605081528-R3","doi-asserted-by":"publisher","first-page":"ciae403","DOI":"10.1093\/cid\/ciae403","article-title":"Infectious Diseases Society of America 2024 guidance on the treatment of antimicrobial-resistant gram-negative infections.","volume":"8","author":"Tamma","year":"2024","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R4","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1093\/jac\/dkae393","article-title":"Global emergence of Escherichia coli with PBP3 insertions.","volume":"80","author":"Long","year":"2025","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R5","doi-asserted-by":"publisher","first-page":"e0154823","DOI":"10.1128\/aac.01548-23","article-title":"Effect of modification of penicillin-binding protein 3 on susceptibility to ceftazidime-avibactam, imipenem-relebactam, meropenem-vaborbactam, aztreonam-avibactam, cefepime-taniborbactam, and cefiderocol of Escherichia coli strains producing broad-spectrum \u03b2-lactamases.","volume":"68","author":"Le Terrier","year":"2024","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R6","doi-asserted-by":"publisher","first-page":"dlaa081","DOI":"10.1093\/jacamr\/dlaa081","article-title":"Escherichia coli strains possessing a four amino acid YRIN insertion in PBP3 identified as part of the SIDERO-WT-2014 surveillance study.","volume":"2","author":"Sato","year":"2020","journal-title":"JAC Antimicrob Resist"},{"key":"key-10.3201\/eid3206.260478-202605081528-R7","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1093\/jac\/dku568","article-title":"Characterization of Escherichia coli NDM isolates with decreased susceptibility to aztreonam\/avibactam: role of a novel insertion in PBP3.","volume":"70","author":"Alm","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R8","doi-asserted-by":"publisher","first-page":"e0267021","DOI":"10.1128\/spectrum.02670-21","article-title":"Occurrence of high levels of cefiderocol resistance in carbapenem-resistant Escherichia coli before its approval in China: a report from China CRE-Network.","volume":"10","author":"Wang","year":"2022","journal-title":"Microbiol Spectr"},{"key":"key-10.3201\/eid3206.260478-202605081528-R9","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/s10096-024-04769-z","article-title":"Reduced susceptibility to aztreonam-avibactam conferred by acquired AmpC-type \u03b2-lactamases in PBP3-modified Escherichia coli.","volume":"2","author":"Helsens","year":"2024","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R10","doi-asserted-by":"publisher","first-page":"e0088725","DOI":"10.1128\/aac.00887-25","article-title":"Optimizing target inactivation to treat multidrug-resistant Escherichia coli with NDM and PBP3 mutations: \u201cgoing the extra mile.\u201d","volume":"20","author":"Fabrizio","year":"2026","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R11","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1093\/cid\/ciad759","article-title":"Sequential treatment failure with aztreonam-ceftazidime-avibactam followed by cefiderocol due to preexisting and acquired mechanisms in a New Delhi metallo-\u03b2-lactamase\u2013producing Escherichia coli causing fatal bloodstream infection.","volume":"78","author":"Senchyna","year":"2024","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R12","doi-asserted-by":"publisher","first-page":"ofad276","DOI":"10.1093\/ofid\/ofad276","article-title":"An NDM-producing Escherichia coli clinical isolate exhibiting resistance to cefiderocol and the combination of ceftazidime-avibactam and aztreonam: another step toward pan\u2013\u03b2-lactam resistance.","volume":"10","author":"Simner","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R13","doi-asserted-by":"publisher","first-page":"2042","DOI":"10.1080\/22221751.2021.1984182","article-title":"Mutations in porin LamB contribute to ceftazidime-avibactam resistance in KPC-producing Klebsiella pneumoniae.","volume":"10","author":"Guo","year":"2021","journal-title":"Emerg Microbes Infect"},{"key":"key-10.3201\/eid3206.260478-202605081528-R14","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1093\/jac\/dkae452","article-title":"Frequencies and mechanisms of mutational resistance to ceftibuten\/avibactam in Enterobacterales.","volume":"80","author":"Mushtaq","year":"2025","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R15","doi-asserted-by":"publisher","first-page":"1570278","DOI":"10.3389\/fphar.2025.1570278","article-title":"From genomics to treatment: overcoming pan\u2013drug-resistant Klebsiella pneumoniae in clinical settings.","volume":"16","author":"Pasteran","year":"2025","journal-title":"Front Pharmacol"},{"key":"key-10.3201\/eid3206.260478-202605081528-R16","unstructured":"Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; thirty-fifth informational supplement (M100-S35). Wayne (PA): The Institute; 2025."},{"key":"key-10.3201\/eid3206.260478-202605081528-R17","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/S1473-3099(19)30755-8","article-title":"Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): a prospective cohort study.","volume":"20","author":"van Duin","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R18","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/S1473-3099(21)00399-6","article-title":"Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study.","volume":"22","author":"Wang","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"key-10.3201\/eid3206.260478-202605081528-R19","doi-asserted-by":"publisher","first-page":"e00843","DOI":"10.1128\/AAC.00843-20","article-title":"CRISPR-Cas9\u2013mediated carbapenemase gene and plasmid curing in carbapenem-resistant Enterobacteriaceae.","volume":"64","author":"Hao","year":"2020","journal-title":"Antimicrob Agents Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R20","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1093\/jac\/dkz468","article-title":"In vitro selection of aztreonam\/avibactam resistance in dual-carbapenemase-producing Klebsiella pneumoniae.","volume":"75","author":"Niu","year":"2020","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R21","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1002\/cpt.2205","article-title":"Combating multidrug-resistant bacteria by integrating a novel target site penetration and receptor binding assay platform into translational modeling.","volume":"109","author":"Lang","year":"2021","journal-title":"Clin Pharmacol Ther"},{"key":"key-10.3201\/eid3206.260478-202605081528-R22","doi-asserted-by":"publisher","first-page":"2833","DOI":"10.1093\/jac\/dkab279","article-title":"Investigation of mechanisms responsible for decreased susceptibility of aztreonam\/avibactam activity in clinical isolates of Enterobacterales collected in Europe, Asia and Latin America in 2019.","volume":"76","author":"Mendes","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid3206.260478-202605081528-R23","doi-asserted-by":"publisher","first-page":"e00821","DOI":"10.1128\/mSystems.00821-20","article-title":"Struggle to survive: the choir of target alteration, hydrolyzing enzyme, and plasmid expression as a novel aztreonam-avibactam resistance mechanism.","volume":"5","author":"Ma","year":"2020","journal-title":"mSystems"},{"key":"key-10.3201\/eid3206.260478-202605081528-R24","doi-asserted-by":"publisher","first-page":"2834","DOI":"10.3389\/fmicb.2018.02834","article-title":"Network EuSCAPE-Portugal. Molecular epidemiology and risk factors of carbapenemase-producing Enterobacteriaceae isolates in Portuguese hospitals: results from European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE).","volume":"9","author":"Manageiro","year":"2018","journal-title":"Front Microbiol"},{"key":"key-10.3201\/eid3206.260478-202605081528-R25","doi-asserted-by":"publisher","first-page":"106642","DOI":"10.1016\/j.ijantimicag.2022.106642","article-title":"Aztreonam-avibactam may not replace ceftazidime\/avibactam: the case of KPC-21 carbapenemase and penicillin-binding protein 3 with four extra amino acids.","volume":"60","author":"Ma","year":"2022","journal-title":"Int J Antimicrob Agents"},{"key":"key-10.3201\/eid3206.260478-202605081528-R26","doi-asserted-by":"publisher","first-page":"103998","DOI":"10.1016\/j.ebiom.2022.103998","article-title":"Klebsiella species: taxonomy, hypervirulence and multidrug resistance.","volume":"79","author":"Dong","year":"2022","journal-title":"EBioMedicine"},{"key":"key-10.3201\/eid3206.260478-202605081528-R27","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.tim.2020.04.012","article-title":"Carbapenem resistance\u2013encoding and virulence-encoding conjugative plasmids in Klebsiella pneumoniae.","volume":"29","author":"Yang","year":"2021","journal-title":"Trends Microbiol"},{"key":"key-10.3201\/eid3206.260478-202605081528-R28","doi-asserted-by":"publisher","first-page":"S72","DOI":"10.1093\/infdis\/jiaf635","article-title":"Carbapenem-resistant Klebsiella pneumoniae of sequence type 11: a scoping review.","volume":"233","author":"Yang","year":"2026","journal-title":"J Infect Dis"}],"container-title":["Emerging Infectious Diseases"],"original-title":[],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T19:28:49Z","timestamp":1778268529000},"score":1,"resource":{"primary":{"URL":"https:\/\/wwwnc.cdc.gov\/eid\/article\/32\/6\/26-0478_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.3201\/eid3206.260478","relation":{},"ISSN":["1080-6040","1080-6059"],"issn-type":[{"value":"1080-6040","type":"print"},{"value":"1080-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}