{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T13:44:23Z","timestamp":1778939063346,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T00:00:00Z","timestamp":1496188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gramnegative bacteria a global spread of extendedspectrum beta-lactamases and carbapenemases producing Klebsiella pneumoniae has been observed. Treatment options for multidrug-resistant K. pneumoniae are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline- resistant K. pneumoniae is increasing globally. Infection due to colistin-resistant K. pneumoniae represents an independent risk factor for mortality. Resistance to colistin in K. pneumoniae may be multifactorial, as it is mediated by chromosomal genes or plasmids. The emergence of transmissible, plasmidmediated colistin resistance is an alarming finding. The absence of new agents effective against resistant Gram-negative pathogens means that enhanced surveillance, compliance with infection prevention procedures, and antimicrobial stewardship programs will be required to limit the spread of colistinresistant K. pneumoniae.<\/jats:p>","DOI":"10.4081\/idr.2017.7104","type":"journal-article","created":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T14:26:51Z","timestamp":1496240811000},"page":"7104","source":"Crossref","is-referenced-by-count":20,"title":["Resistance to Colistin in Klebsiella pneumoniae: A 4.0 Strain?"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5796-0545","authenticated-orcid":false,"given":"Guido","family":"Granata","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2585-7567","authenticated-orcid":false,"given":"Nicola","family":"Petrosillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,5,31]]},"reference":[{"key":"ref1","series-title":"Plasmid-mediated colistin resistance in Enterobacteriaceae","year":"2016"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/BF01641355","article-title":"Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens","volume":"11","author":"Knothe","year":"1983","journal-title":"Infection"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"7693","DOI":"10.1073\/pnas.91.16.7693","article-title":"Analysis of a carbapenem-hydrolyzing class A \u03b2-lactamase from Enterobacter cloacae and of its LysR-type regulatory protein","volume":"91","author":"Naas","year":"1994","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(05)75604-X","article-title":"Carbapenem-hydrolysing IMP-1 beta-lactamase in Klebsiella pneumoniae from Singapore","volume":"353","author":"Koh","year":"1999","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1128\/AAC.48.1.15-22.2004","article-title":"Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae","volume":"48","author":"Poirel","year":"2004","journal-title":"Antimicrob Agents Chemother"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1128\/AAC.45.8.2368-2371.2001","article-title":"Identification of a plasmid encoding SHV-12, TEM-1, and a variant of IMP-2 metallo-beta-lactamase, IMP-8, from a clinical isolate of Klebsiella pneumoniae","volume":"45","author":"Yan","year":"2001","journal-title":"Antimicrob Agents Chemother"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"i29","DOI":"10.1093\/jac\/dkp255","article-title":"Has the era of untreatable infections arrived?","volume":"64","author":"Livermore","year":"2009","journal-title":"J Antimicrob Chemother"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1111\/1469-0691.12719","article-title":"The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide","volume":"20","author":"Nordmann","year":"2014","journal-title":"Clin Microbiol Infect"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.diagmicrobio.2012.11.009","article-title":"Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes","volume":"75","author":"van Duin","year":"2013","journal-title":"Diagn Microbiol Infect Dis"},{"key":"ref10","first-page":"139","article-title":"Tigecycline susceptibility and molecular resistance mechanisms among clinical Klebsiella pneumoniae strains isolated during non-tigecycline treatment. 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