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The Rise of NDM and OXA-48–Like Enterobacterales in the United States

Clinical Thought

The era of KPC enzyme dominance in the US may be ending, as we are now witnessing a shift towards carbapenem-resistant Enterobacterales (CRE) driven by NDM and OXA-48–like β-lactamases. Read on to discover the therapeutic implications of this shift.

Released: March 02, 2026

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Provided by Clinical Care Options, LLC, in partnership with ProCE, LLC

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Supporters

Supported by an educational grant from Shionogi Pharma, Inc.

Shionogi Pharma, Inc.

Partners

ProCE, LLC

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Target Audience

This activity is intended for pulmonology, critical care, and infectious disease specialists, including physicians and clinical pharmacists, who care for critically ill patients with carbapenem-resistant gram-negative infections.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Recognize the importance of antimicrobial susceptibility testing to determine the mechanisms of resistance for CRE

  • Identify appropriate antimicrobial regimens for infections caused by CRE with NDM and OXA-48-like enzymes

Disclosure

Primary Author

Ryan K. Shields, PharmD, MS: consultant/advisor/speaker: AbbVie, BioMerieux, GSK, Innoviva, Melinta, Merck, Qpex, Roche, Shionogi; researcher: AbbVie, Innoviva, Melinta, Merck, Shionogi.