{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:55:54Z","timestamp":1785308154118,"version":"3.55.0"},"reference-count":66,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University statutory funding","award":["SUBZ.E090.22.103"],"award-info":[{"award-number":["SUBZ.E090.22.103"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The global emergence and spread of genes responsible for the production of ESBL (extended-spectrum beta-lactamases) and carbapenemases in Klebsiella pneumoniae isolates poses a serious threat to public health. The aim of this study was to retrospectively analyze the frequency of occurrence and drug resistance of selected alarm agents isolated from patients of the specialist hospital in Wroc\u0142aw. A total of 13,528 clinical materials collected from patients of a specialist hospital in Wroc\u0142aw were analyzed in the period from 1 January 2020 to 31 December 2020. Overall, 3894 bacterial strains were isolated from clinical materials, including 416 K. pneumoniae isolates. K. pneumoniae that showed resistance to ETP (ertapenem) and\/or MEM (meropenem) were tested using phenotypic tests for the detection of KPC (carbapenemase-producing Klebsiella), MBL (metallo-\u03b2-lactamase) and OXA-48 (oxacilinase-48) carbapenemases. In the case of a positive or doubtful result of the phenotypic test, immunochromatographic tests and the CarbaNP test were performed. In total, 58 K. pneumoniae isolates resistant to 1 or more carbapenem antibiotics were isolated. Of the 58 strains, 16 (27.6%) were isolated from rectal swabs conducted on CPE (carbapenemase-producing Enterobacteriaceae) carriers. In the case of CRE (carbapenem-resistant Enterobacteriaceae) K. pneumoniae, carbapenemases were detected in 28\/58 (48.3%) isolates. Notably, 23\/28 K. pneumoniae isolates produced MBL\/NDM (New Delhi metallo-\u03b2-lactamase) (82.1%), 5\/28 produced VIM (Verona-intergon-encoded metallo-\u03b2-lactamase) (14.3%), and one produced MBL\/NDM + OXA-48. Carbapenemases were detected in 13 of 16 (81.3%) carbapenem-resistant K. pneumoniae isolates derived from rectal swabs. The significant participation of CRE and CPE isolates in the infections proves the need to test patients admitted to hospital wards for their status as a CPE carrier in order to limit the emergence of new epidemic outbreaks.<\/jats:p>","DOI":"10.3390\/pathogens11080859","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T04:04:00Z","timestamp":1659326640000},"page":"859","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Occurrence and Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated from Hospitalized Patients in Poland\u2014A Single Centre Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Jolanta","family":"Sarowska","sequence":"first","affiliation":[{"name":"Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena","family":"Choroszy-Krol","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Jama-Kmiecik","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-7970","authenticated-orcid":false,"given":"Beata","family":"M\u0105czy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Microbiology and Parasitology, Faculty of Pharmacy, Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia","family":"Cholewa","sequence":"additional","affiliation":[{"name":"Medical Laboratory Synevo, Fieldorfa 2, 50-049 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Frej-Madrzak","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1128\/MMBR.00016-10","article-title":"Origins and evolution of antibiotic resistance","volume":"74","author":"Davies","year":"2010","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_2","first-page":"15","article-title":"Carbapenem resistance: Overview of the problem and future perspectives","volume":"3","author":"Meletis","year":"2016","journal-title":"Ther. Adv. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/j.1749-6632.2012.06796.x","article-title":"Metallo-\u03b2-lactamase structure and function","volume":"1277","author":"Palzkill","year":"2013","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.ejmech.2020.112829","article-title":"\u03b2-lactam antibiotics: An overview from a medicinal chemistry perspective","volume":"208","author":"Lima","year":"2020","journal-title":"Eur. J. Med. Chem."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/jac\/dkv282","article-title":"NDM-producing Enterobacteriaceae in Poland, 2012\u20132014: Inter-regional outbreak of Klebsiella pneumoniae ST11 and sporadic cases","volume":"71","author":"Baraniak","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ejmech.2017.03.022","article-title":"Recent updates of carbapenem antibiotics","volume":"131","author":"Brahim","year":"2017","journal-title":"Eur. J. Med. Chem."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S521","DOI":"10.1093\/cid\/ciz824","article-title":"Epidemiology and Diagnostics of Carbapenem Resistance in Gram-negative Bacteria","volume":"13","author":"Nordmann","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Codjoe, F.S., and Donkor, E.S. (2017). Carbapenem Resistance: A Review. Med. Sci., 21.","DOI":"10.3390\/medsci6010001"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ijmm.2010.04.005","article-title":"Resistance to cephalosporins and carbapenems in Gram-negative bacterial pathogens","volume":"300","author":"Pfeifer","year":"2010","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.micpath.2019.05.022","article-title":"Impact of specific inhibitors on metallo-\u03b2-carbapenemases detected in Escherichia coli and Klebsiella pneumoniae isolates","volume":"132","author":"Abbas","year":"2019","journal-title":"Microb. Pathog."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1093\/infdis\/jiw282","article-title":"The epidemiology of carbapenem-resistant enterobacteriaceae: The impact and evolution of a global menace","volume":"215","author":"Logan","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5917","DOI":"10.1038\/s41598-017-06256-2","article-title":"Genomic epidemiology of global Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli","volume":"7","author":"Stoesser","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"FSO438","DOI":"10.2144\/fsoa-2019-0098","article-title":"A review on bacterial resistance to carbapenems: Epidemiology, detection and treatment options","volume":"6","author":"Elshamy","year":"2020","journal-title":"Future Sci. OA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e00115-18","DOI":"10.1128\/CMR.00115-18","article-title":"NDM Metallo-\u03b2-Lactamases and Their Bacterial Producers in Health Care Settings","volume":"32","author":"Wu","year":"2019","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_15","unstructured":"(2021, May 31). Criteria for Diagnosis of an Outbreak in a Hospital\/Health Care Facility Caused by Carbapenamase-Producing Strains of Enterobacteriaceae (CPE). Guidelines of the National Antibiotic Protection Program. Available online: http:\/\/antybiotyki.edu.pl\/wp-content\/uploads\/dokumenty\/CPE_NDM-Ognisko-epidemiczne.pdf."},{"key":"ref_16","unstructured":"ECDC (2020). Antimicrobial consumption in the EU\/EEA\u2014Annual Epidemiological Report 2019. Stockholm, 11, 1\u201325."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5046","DOI":"10.1128\/AAC.00774-09","article-title":"Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India","volume":"53","author":"Yong","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S1473-3099(13)70190-7","article-title":"Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases","volume":"13","author":"Poirel","year":"2013","journal-title":"Lancet Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1128\/AAC.01197-13","article-title":"The first NDM metallo-\u03b2-lactamase-producing Enterobacteriaceae isolate in Poland: Evolution of IncFII-type plasmids carrying the bla(NDM-1) gene","volume":"58","author":"Fiett","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5493","DOI":"10.1128\/AAC.05118-11","article-title":"KPC-PL Study Group. Molecular characteristics of KPC-producing Enterobacteriaceae at the early stage of their dissemination in Poland, 2008\u20132009","volume":"55","author":"Baraniak","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1111\/j.1469-0691.2012.03821.x","article-title":"European Network on Carbapenemases. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe","volume":"18","author":"Carmeli","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1093\/jac\/dkx054","article-title":"KPC-PL2 Study Group. Multiregional dissemination of KPC-producing Klebsiella pneumoniae ST258\/ST512 genotypes in Poland, 2010\u20132014","volume":"72","author":"Baraniak","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1080\/21505594.2016.1222343","article-title":"The global epidemiology of carbapenemase-producing Enterobacteriaceae","volume":"8","author":"Doi","year":"2017","journal-title":"Virulence"},{"key":"ref_24","unstructured":"Literacka, E., \u017babicka, D., Hryniewicz, W., and Gniadkowski, M. (2019, June 30). Report of the National Reference Center for Antimicrobial Susceptibility. Data from the National Reference Center for Antimicrobial Susceptibility on Enterobacterales, Producing NDM, KPC, VIM and OXA-48 Carbapenemases in Poland in 2006\u20132018, Available online: https:\/\/korld.nil.gov.pl\/pdf\/Raport%20KORLD%202019_EL_2.pdf."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Hammoudi Halat, D., and Ayoub Moubareck, C. (2020). The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria. Antibiotics, 9.","DOI":"10.3390\/antibiotics9040186"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s40121-020-00395-2","article-title":"Continuous Evolution: Perspective on the Epidemiology of Carbapenemase Resistance Among Enterobacterales and Other Gram-Negative Bacteria","volume":"10","author":"Hansen","year":"2021","journal-title":"Infect. Dis. Ther."},{"key":"ref_27","unstructured":"World Health Organization (WHO) (2015). Global Antimicrobial Resistance Surveillance System, WHO."},{"key":"ref_28","unstructured":"World Health Orgnazation (WHO) (2020). Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report, WHO."},{"key":"ref_29","unstructured":"World Health Orgnazation (WHO) (2016). Situation Analysis on Antimicrobial Resistance in the South-East Asia Region, WHO."},{"key":"ref_30","unstructured":"World Health Orgnazation (WHO) (2018). Central Asian and Eastern European Surveillance of Antimicrobial Resistance, WHO."},{"key":"ref_31","unstructured":"\u017babicka, D., Literacka, E., Gniadkowski, M., and Hryniewicz, W. (2017, December 20). Report of the National Reference Center for Antimicrobial Susceptibility. Occurrence of Enterobacteriaceae (mainly Klebsiella pneumoniae), producing New Delhi carbapenemase (NDM) in Poland in Q1\u2013Q3 2017. KORLD. Available online: http:\/\/www.korld.edu.pl\/pdf\/Raport_NDM_18-12-2017."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1093\/jac\/dkaa339","article-title":"Genomic background of the Klebsiella pneumoniae NDM-1 outbreak in Poland, 2012\u20132018","volume":"75","author":"Izdebski","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"107","DOI":"10.33073\/pjm-2021-010","article-title":"Clonal Dissemination of KPC-2, VIM-1, OXA-48-Producing Klebsiella pneumoniae ST147 in Katowice, Poland","volume":"70","author":"Dobrut","year":"2021","journal-title":"Pol. J. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s13756-019-0591-6","article-title":"Screening for carriage of carbapenem-resistant Enterobacteriaceae in settings of high endemicity: A position paper from an Italian working group on CRE infections","volume":"8","author":"Ambretti","year":"2019","journal-title":"Antimicrob Resist. Infect. Control"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"716324","DOI":"10.3389\/fphar.2021.716324","article-title":"Clinical and Microbiological Characterization of Carbapenem-Resistant Enterobacteriales: A Prospective Cohort Study","volume":"12","author":"Lin","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Loqman, S., Soraa, N., Diene, S.M., and Rolain, J.-M. (2021). Dissemination of Carbapenemases (OXA-48, NDM and VIM) Producing Enterobacteriaceae Isolated from the Mohamed VI University Hospital in Marrakech, Morocco. Antibiotics, 10.","DOI":"10.3390\/antibiotics10050492"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.2147\/IDR.S181085","article-title":"Ertapenem non-susceptibility and independent predictors of the carbapenemase production among the Enterobacteriaceae isolates causing intra-abdominal infections in the asia-pacific region: Results from the study for monitoring antimicrobial resistance trends (SMART)","volume":"11","author":"Jean","year":"2018","journal-title":"Infect. Drug Resist."},{"key":"ref_38","unstructured":"European Centre for Disease Prevention and Control (2020, November 18). Antimicrobial Resistance in the EU\/EEA (EARS-Net) Annual Epidemiological Report for 2019. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/surveillance-antimicrobial-resistance-europe-2019."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1089\/mdr.2018.0013","article-title":"Occurrence and characterization of carbapenemase-producing Enterobacteriaceae in a Tunisian Hospital","volume":"24","author":"Dziri","year":"2018","journal-title":"Microb. Drug Resist."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kim, Y.K., Chang, I.B., Kim, H.S., Song, W., and Lee, S.S. (2021). Prolonged Carriage of Carbapenemase-Producing Enterobacteriaceae: Clinical Risk Factors and the Influence of Carbapenemase and Organism Types. J. Clin. Med., 10.","DOI":"10.3390\/jcm10020310"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"9299258","DOI":"10.1155\/2022\/9299258","article-title":"Effectiveness of Antiepidemic Measures Aimed to Reduce Carbapenemase-Producing Enterobacteriaceae in the Hospital Environment","volume":"2022","author":"Pawlak","year":"2022","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1128\/AAC.01222-13","article-title":"Antibiotic treatment of infections due to carbapenem-resistant Enterobacteriaceae: Systematic evaluation of the available evidence","volume":"58","author":"Falagas","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_43","first-page":"271","article-title":"Carbapenemase of Intestinal Rods\u2014The Beginning of Post-Antibiotic Era?","volume":"58","author":"Chmielewska","year":"2019","journal-title":"Adv. Microbiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"314","DOI":"10.3389\/fcimb.2020.00314","article-title":"Dissemination of Carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) Among Carbapenem-Resistant Enterobacteriaceae Isolated From Adult and Children Patients in China","volume":"10","author":"Han","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_45","unstructured":"Tacconelli, E., and Magrini, N. (2017, June 01). Global Priority List of Antibiotic\u2014Resistant Bacteria to Guide Research, Discovery and Development of New Antibiotics. Available online: https:\/\/www.quotidianosanita.it\/allegati\/allegato4135670.pdf."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"M\u0105czy\u0144ska, B., Paleczny, J., Oleksy-Wawrzyniak, M., Choroszy-Kr\u00f3l, I., and Bartoszewicz, M. (2021). In Vitro Susceptibility of Multi-Drug Resistant Klebsiella pneumoniae Strains Causing Nosocomial Infections to Fosfomycin. A Comparison of Determination Methods. Pathogens, 10.","DOI":"10.3390\/pathogens10050512"},{"key":"ref_47","first-page":"239","article-title":"The occurence and pathogenicity of B-class carbapenemase\u2014Producing Enterobacteriaceae\u2014Klebsiella pneumoniae strains (MBL\/NDM) in patients hospitalized and treated in Mazowiecki Memorial Hospital of Radom between 2016\u20132018","volume":"3","author":"Ura","year":"2020","journal-title":"Long-Term Care Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"6634684","DOI":"10.1155\/2021\/6634684","article-title":"Colistin Resistance among Enterobacteriaceae Isolated from Clinical Samples in Gaza Strip","volume":"2021","author":"Qadi","year":"2021","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S1473-3099(18)30099-9","article-title":"Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria: An open-label, randomised controlled trial","volume":"18","author":"Paul","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1089\/mdr.2018.0234","article-title":"Activity of Ceftazidime-Avibactam Alone and in Combination with Ertapenem, Fosfomycin, and Tigecycline Against Carbapenemase-Producing Klebsiella pneumoniae","volume":"25","author":"Ojdana","year":"2019","journal-title":"Microb. Drug Resist."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ijantimicag.2018.10.010","article-title":"Combination therapy with polymyxin B for carbapenemase-producing Klebsiella pneumoniae bloodstream infection","volume":"53","author":"Medeiros","year":"2019","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.3389\/fphar.2019.01673","article-title":"Triple Versus Double Therapy for the Treatment of Severe Infections Caused by Carbapenem-Resistant Enterobacteriaceae: A Systematic Review and Meta-Analysis","volume":"10","author":"Wang","year":"2020","journal-title":"Front. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1128\/AAC.47.8.2565-2571.2003","article-title":"Plasmid-mediated high-level resistance to aminoglycosides in Enterobacteriaceae due to 16S rRNA methylation","volume":"47","author":"Galimand","year":"2003","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"5120","DOI":"10.1086\/428052","article-title":"Mechanism of Resistant to Quinolones","volume":"41","author":"Jacoby","year":"2005","journal-title":"Clin. Inf. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"4742","DOI":"10.1128\/AAC.00309-11","article-title":"OmpK26, A novel porin associated with carbapenem resistance in Klebsiella pneumoniae","volume":"55","author":"Barbier","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_56","first-page":"1128","article-title":"Klebsiella pneumoniae AcrAB efflux pump contribute to antimicrobial resustance and virulence","volume":"10","author":"Padilla","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1093\/jac\/dkq408","article-title":"Activity of aminoglycosides, including ACHN-490, against carbapenem-resistant Enterobacteriaceae isolates","volume":"66","author":"Livermore","year":"2011","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1476-0711-11-32","article-title":"Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: A review of published case series and case reports","volume":"11","author":"Lee","year":"2012","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_59","first-page":"147","article-title":"New Delhi Metallo-beta lactamase (NDM-1) in Enterobacteriaceae: Treatment options with carbapenems compromised","volume":"58","author":"Deshpande","year":"2010","journal-title":"J. Assoc. Physicians India"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1111\/imj.13642","article-title":"Healthcare-acquired infections: Prevention strategies","volume":"47","author":"Fernando","year":"2017","journal-title":"Intern. Med. J."},{"key":"ref_61","unstructured":"EUCAST (2020). The European Committee on Antimicrobial Susceptibility Testing. Breakpoint Tables for Interpretation of MICs and Zone Diameters, The European Committee on Antimicrobial Susceptibility Testing. Version 10.0."},{"key":"ref_62","unstructured":"EUCAST (2020). The European Committee on Antimicrobial Susceptibility Testing. Routine and Extended Internal Quality Control for MIC Determination and Disk Diffusion as Recommended by EUCAST, The European Committee on Antimicrobial Susceptibility Testing. Version 10.0."},{"key":"ref_63","unstructured":"\u017babicka, D., and Hryniewicz, W. (2020). Interpretation Tables of Susceptibility Testing Results According to EUCAST 2018 Recommendations."},{"key":"ref_64","unstructured":"Skov, R., and Skov, G. (2022, June 01). EUCAST Guidelines for Detection of Resistance Mechanisms and Specific Resistances of Clinical and\/or Epidemiological Importance. Available online: https:\/\/www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/Resistance_mechanisms\/EUCAST_detection_of_resistance_mechanisms_170711.pdf."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/1469-0691.12322","article-title":"A disc diffusion assay for detection of class A, B and OXA-48 carbapenemases in Enterobacteriaceae using phenyl bo ronic acid, dipicolinic acid and temocillin","volume":"20","author":"Voets","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1128\/JCM.00594-14","article-title":"CarbAcineto NP test for rapid detection of carbapenemase-producing Acinetobacter spp.","volume":"52","author":"Dortet","year":"2014","journal-title":"J. Clin. Microbiol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/8\/859\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:59:35Z","timestamp":1760140775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/8\/859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,29]]},"references-count":66,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["pathogens11080859"],"URL":"https:\/\/doi.org\/10.3390\/pathogens11080859","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,29]]}}}