Rossel, Connor AJHendrickx, Antoni PAvan Alphen, Lieke Bvan der Horst, Robrecht PJJanssen, Augustinus HJWKooyman, Cornelia CHeddema, Edou R2024-08-232024-08-232024-08-133913494110.1186/s12879-024-09722-1http://hdl.handle.net/10029/627802A Dutch patient who carried NDM-1-producing CPPA was transferred from Kenya to the Netherlands, with subsequent dissemination of CPPA isolates to the local sinks within a month after admission. The CPPA case isolates presented an extensively drug-resistant phenotype, with susceptibility only for colistin and cefiderocol-fosfomycin. Phylogenetic analysis showed considerable variation in allelic distances (mean = 150, max = 527 alleles) among the ST357 isolates from Asia (n = 92), Europe (n = 58), Africa (n = 21), America (n = 16), Oceania (n = 2) and unregistered regions (n = 4). However, the case isolates (n = 3) and additional Dutch patient surveillance program isolates (n = 2) were located in a sub-clade of isolates from Kenya (n = 17; varying 15-49 alleles), the United States (n = 7; 21-115 alleles) and other countries (n = 6; 14-121 alleles). This was consistent with previous hospitalization in Kenya of 2/3 Dutch patients. Additionally, over half of the isolates (20/35) in this sub-clade presented an identical resistome with 9/17 Kenyan, 5/5 Dutch, 4/7 United States and 2/6 other countries, which were characterized by the blaNDM-1, aph(3')-VI, ARR-3 and cmlA1 ARGs.en© 2024. The Author(s).Pseudomonas aeruginosaCarbapenemase-producingExtensively-drug resistantRepatriationST357SinkArticle1471-2334BMC Infect Dis 2024; 24(1):817