Coexistence of blaNDM−1, blaIMP−4and blaOXA−181 in Citrobacter braakii clinical isolate in China

we isolated a C. braakii W221 co-existing blaNDM-1, blaIMP-4, and blaOXA-181, and this was first reported in the world. The presence of multiple transferrable and mobilizable plasmids carrying key resistance determinants suggested that this strain may have high potential for horizontal gene transfer and rapid dissemination. These findings suggesting that clinical settings should be vigilant against the further emergence, spread and prevalence of such novel multidrug-resistant strains.