Work

Co-occurrence and genetic contexts of NDM-1, KPC-2, IMP-1, and AFM-1 carbapenemase genes in a critically ill patient

Year: 2026

Type: article

Abstract: Background Carbapenem-resistant organisms are increasingly reported in clinical settings, yet the simultaneous detection of multiple carbapenemase genes within a single specimen remains rare. Methods Metagenomic next-generation sequencing (mNGS) and whole-genome sequencing (WGS) were performed on a bronchoalveolar lavage fluid (BALF) sample from a patient with severe pneumonia. Results Four carbapenemase genes— bla AFM-1 , bla NDM-1 , bla IMP-1 , and bla KPC-2 —were simultaneously detected in a single specimen. Three carbapenem-resistant isolates were recovered: an ST11 K. pneumoniae carrying bla KPC-2 and virulence-associated genes, an S. algae strain with an assembly-based tandem chromosomal bla NDM-1 arrangement, and a P. stutzeri strain co-harboring bla AFM-1 and bla IMP-1 . Genomic analysis revealed complex mobile genetic contexts associated with these resistance determinants. Conclusion The coexistence of four carbapenemase genes within one clinical sample highlights the complexity of polymicrobial carbapenem resistance and underscores the importance of genomic surveillance.

Source: Frontiers in Cellular and Infection Microbiology

DOI: 10.3389/fcimb.2026.1973471

Authors: Yan Zhang, Zhirong Zhang, Senhong Ying, Sanrong Wang, Rong Xiang

Institution: Second Affiliated Hospital of Chongqing Medical University

Language: English

Topic: Antibiotic Resistance in Bacteria

Subfield: Microbiology (medical)

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801