IMP4 and bacterial urinary tract infection: In particular K. pneumoniae showed a decreasing susceptibility to carbapenems, which was more pronounced in UTI isolates and indicated that carbapenemases or other mechanisms of carbapenem resistance have developed in K. pneumoniae strains, which has also been previously noted since carbapenem resistant K. pneumoniae strains isolated in Shanghai between July 2014 and May 2015 harbored all or at least one of the ESBL genes plus mainly New Delhi metallo-β-lactamase-1 (NDM-1) and IMP-4 or Klebsiella pneumoniae carbapenemase (KPC)-2 [14].