Genomic insights into a multidrug-resistant Pseudomonas aeruginosa ST463 clinical isolate co-harbouring blaKPC-2 and blaNDM-9

OBJECTIVE: , two clinically important carbapenemase genes. METHODS: were inferred by SNP-based analysis and visualized using iTOL. RESULTS: alone are globally prevalent and may serve as reservoirs for the emergence of co-harbouring strains. In contrast, isolates carrying both genes remain rare, with only seven cases reported worldwide to date (2020-2025), suggesting an evolutionary shift toward multi-carbapenemase carriage under the selective pressure of novel β-lactam/β-lactamase inhibitor use. CONCLUSION: . The emergence of multi-carbapenemase-producing strains poses a serious threat to antimicrobial therapy, underscoring the need for continuous clinical surveillance.