{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:01:47Z","timestamp":1789725707797,"version":"4.0.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DISCAB_Grant 2025 of Alessandra Piccirilli"},{"name":"Department of Biotechnological and Applied Clinical Sciences"},{"DOI":"10.13039\/501100006256","name":"University of L\u2019Aquila","doi-asserted-by":"publisher","award":["07_DG_2025_11"],"award-info":[{"award-number":["07_DG_2025_11"]}],"id":[{"id":"10.13039\/501100006256","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Enterobacter hormaechei, a member of the Enterobacter cloacae complex (ECC), is increasingly recognized as an opportunistic pathogen associated with multidrug resistance and nosocomial infections. The emergence of carbapenemase-producing ECC, particularly those harbouring blaNDM-1, represents a significant public health concern. This study aims to provide a comprehensive genomic characterization of an NDM-1-producing E. hormaechei strain (VDL\/23) isolated from the bloodstream of a hospitalized patient in Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The isolate underwent hybrid WGS using Illumina short reads and Oxford Nanopore long reads. Genomic analyses were performed to characterize the resistome, virulome, plasmid content and associated mobile genetic elements. Conjugation assays were conducted using Escherichia coli K-12 as the recipient strain to assess plasmid transferability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>WGS identified the isolate as E. hormaechei subsp. hoffmannii ST145, a lineage sporadically reported worldwide but not previously described in Italy. The genome comprised a chromosome and three plasmids (pVDL\/23-1, pVDL\/23-2, pVDL\/23-3). Chromosomal resistance included blaACT-90, fosA and oqxAB, while the IncF-type plasmid pVDL\/23-2 carried the main acquired resistance genes, including blaNDM-1, blaCTX-M-15, blaOXA-1 and additional determinants for aminoglycoside, trimethoprim and chloramphenicol resistance. Multiple insertion sequences and IncF replicons supported a mobile genetic context, and conjugation assays confirmed plasmid-mediated transfer of resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To the best of our knowledge, this study reports the first identification of an NDM-1-producing E. hormaechei ST145 isolate in Italy. The coexistence of extensive resistance determinants and mobile genetic elements highlights the emergence of a high-risk lineage and reinforces the need for genomic surveillance and infection control strategies to limit its dissemination in healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlag210","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:51:21Z","timestamp":1788954681000},"source":"Crossref","is-referenced-by-count":0,"title":["NDM-1-producing\n                    <i>Enterobacter hormaechei<\/i>\n                    ST145 in Italy: genomic characterization of a multidrug-resistant high-risk clone"],"prefix":"10.1093","volume":"8","author":[{"given":"A","family":"Piccirilli","sequence":"first","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila , L\u2019Aquila ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Alloggia","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila , L\u2019Aquila ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Nicolucci","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila , L\u2019Aquila ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Gambardella","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Luca Hospital, Vallo della Lucania , Salerno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Di Domenico","sequence":"additional","affiliation":[{"name":"Molecular Biology and Genomic Unit, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise \u201cG. Caporale\u201d , Teramo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Camm\u00e0","sequence":"additional","affiliation":[{"name":"Molecular Biology and Genomic Unit, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise \u201cG. Caporale\u201d , Teramo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-7738","authenticated-orcid":false,"given":"L F","family":"Mincarelli","sequence":"additional","affiliation":[{"name":"Molecular Biology and Genomic Unit, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise \u201cG. Caporale\u201d , Teramo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Giordano","sequence":"additional","affiliation":[{"name":"Clinical Pathology, San Luca Hospital, Vallo della Lucania , Salerno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Borriello","sequence":"additional","affiliation":[{"name":"Clinical Pathology, San Luca Hospital, Vallo della Lucania , Salerno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Perilli","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila , L\u2019Aquila ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"2026091805012468100_dlag210-B1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00002-19","article-title":"Enterobacter spp.: update on taxonomy, clinical aspects, and emerging antimicrobial resistance","volume":"32","author":"Davin-Regli","year":"2019","journal-title":"Clin Microbiol Rev"},{"key":"2026091805012468100_dlag210-B2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.jhin.2024.03.010","article-title":"The EC-COMPASS: long-term, multi-centre surveillance of Enterobacter cloacae complex-a clinical perspective","volume":"148","author":"Mauritz","year":"2024","journal-title":"J Hosp Infect"},{"key":"2026091805012468100_dlag210-B3","doi-asserted-by":"publisher","first-page":"5306","DOI":"10.1128\/AEM.69.9.5306-5318.2003","article-title":"Population genetics of the nomenspecies Enterobacter cloacae","volume":"69","author":"Hoffmann","year":"2003","journal-title":"Appl Environ Microbiol"},{"key":"2026091805012468100_dlag210-B4","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.3390\/microorganisms12071441","article-title":"Presence and role of the type 3 fimbria in the adherence capacity of Enterobacter hormaechei subsp. hoffmannii","volume":"12","author":"Fern\u00e1ndez-Y\u00e1\u00f1ez","year":"2024","journal-title":"Microorganisms"},{"key":"2026091805012468100_dlag210-B5","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.jgar.2023.06.009","article-title":"Emergence of carbapenem-resistant Enterobacter hormaechei ST93 plasmids co-harbouring blaNDM-1, blaKPC-2, and mcr-9 in bloodstream infection","volume":"34","author":"Wu","year":"2023","journal-title":"J Glob Antimicrob Resist"},{"key":"2026091805012468100_dlag210-B6","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlag025","article-title":"Enterobacter hormaechei co-harbouring blaKPC-2, blaVIM-24, and blaNDM-1: the rise of the \u2018unholy trinity\u2019","volume":"8","author":"Rojas","year":"2026","journal-title":"JAC Antimicrob Resist"},{"key":"2026091805012468100_dlag210-B7","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1186\/s12864-025-11590-1","article-title":"Pan-genome analysis of the Enterobacter hormaechei complex highlights its genomic flexibility and pertinence as a multidrug-resistant pathogen","volume":"26","author":"De Maayer","year":"2025","journal-title":"BMC Genomics"},{"key":"2026091805012468100_dlag210-B8","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.560488","article-title":"Two type VI secretion systems of Enterobacter cloacae are required for bacterial competition, cell adherence, and intestinal colonization","volume":"11","author":"Soria-Bustos","year":"2020","journal-title":"Front Microbiol"},{"key":"2026091805012468100_dlag210-B9","doi-asserted-by":"publisher","first-page":"249","DOI":"10.53854\/liim-3303-1","article-title":"The burden of infections caused by metallo-beta-lactamase-producing Enterobacterales in Italy: epidemiology, outcomes, and management","volume":"33","author":"Tiseo","year":"2025","journal-title":"Infez Med"},{"key":"2026091805012468100_dlag210-B10","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa011","article-title":"Clinical features and outcomes of bloodstream infections caused by New Delhi metallo-\u03b2-lactamase-producing Enterobacterales during a regional outbreak","volume":"7","author":"Falcone","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2026091805012468100_dlag210-B11","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.jgar.2024.01.015","article-title":"Genomic surveillance of carbapenem-resistant Klebsiella pneumoniae reveals a prolonged outbreak of extensively drug-resistant ST147 NDM-1 during the COVID-19 pandemic in the Apulia region (Southern Italy)","volume":"36","author":"Loconsole","year":"2024","journal-title":"J Glob Antimicrob Resist"},{"key":"2026091805012468100_dlag210-B12","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2023.28.42.2300522","article-title":"Rapid spread of a novel NDM-producing clone of Klebsiella pneumoniae CC147, Northern Italy, February to August 2023","volume":"28","author":"Mileto","year":"2023","journal-title":"Euro Surveill"},{"key":"2026091805012468100_dlag210-B13","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.3201\/eid3110.250830","article-title":"Emergence and polyclonal dissemination of blaNDM-7\u2013carrying InX3 plasmid in Enterobacter cloacae Complex, France, 2021\u20132023","volume":"31","author":"Rezzoug","year":"2025","journal-title":"Emerg Infect Dis"},{"key":"2026091805012468100_dlag210-B14","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing-Thirty-Fourth Edition: M100","author":"CLSI","year":"2024"},{"key":"2026091805012468100_dlag210-B15","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.jgar.2025.06.014","article-title":"OXA-carbapenemases and mutations within PBPs in ST2 carbapenem-resistant A. baumannii: evaluating the efficacy of cefiderocol and ampicillin-sulbactam combination therapy","volume":"44","author":"Tascini","year":"2025","journal-title":"J Glob Antimicrob Resist"},{"key":"2026091805012468100_dlag210-B16","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1093\/jac\/dkab471","article-title":"Emergence of VIM-producing Enterobacter cloacae complex in France between 2015 and 2018","volume":"77","author":"Emeraud","year":"2022","journal-title":"J Antimicrob Chemother"},{"key":"2026091805012468100_dlag210-B17","doi-asserted-by":"publisher","first-page":"387","DOI":"10.3390\/antibiotics15040387","article-title":"Whole-genome sequencing reveals heterogeneous resistance profiles and selected mobile genetic elements in Ecuadorian clinical Enterobacter hormaechei subsp. xiangfangensis and subsp. hoffmannii","volume":"15","author":"Bejarano","year":"2026","journal-title":"Antibiotics (Basel)"},{"key":"2026091805012468100_dlag210-B18","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.diagmicrobio.2017.10.007","article-title":"Occurrence of Enterobacter hormaechei carrying blaNDM-1 and blaKPC-2 in China","volume":"90","author":"Yang","year":"2018","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2026091805012468100_dlag210-B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2021.104924","article-title":"Molecular characterization of a carbapenem-resistant Enterobacter hormaechei ssp. xiangfangensis co-harbouring blaNDM-1 and a chromosomally encoded phage-linked blaCTX-M-15 genes","volume":"93","author":"Makhlouf","year":"2021","journal-title":"Infect Genet Evol"},{"key":"2026091805012468100_dlag210-B20","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3390\/genes8110337","article-title":"The obscure world of integrative and mobilizable elements, highly widespread elements that pirate bacterial conjugative systems","volume":"8","author":"Gu\u00e9don","year":"2017","journal-title":"Genes (Basel)"}],"container-title":["JAC-Antimicrobial Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jacamr\/article-pdf\/8\/5\/dlag210\/71220917\/dlag210.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jacamr\/article-pdf\/8\/5\/dlag210\/71220917\/dlag210.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:01:33Z","timestamp":1789722093000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jacamr\/article\/doi\/10.1093\/jacamr\/dlag210\/8816874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jacamr\/dlag210","relation":{},"ISSN":["2632-1823"],"issn-type":[{"value":"2632-1823","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,1]]},"article-number":"dlag210"}}