{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:59:18Z","timestamp":1787504358762,"version":"build-2736575974"},"reference-count":55,"publisher":"Microbiology Society","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016994","name":"Universitetssykehuset Nord-Norge","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100016994","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction.<\/jats:bold>\n                    Infections by carbapenemase-producing\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    (CP-Pa) are concerning due to limited treatment options. The emergence of multidrug-resistant (MDR) high-risk clones is an essential driver in the global rise of CP-Pa.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Hypothesis\/Gap Statement.<\/jats:bold>\n                    Insights into the molecular epidemiology of CP-Pa are crucial to understanding its clinical and public health impact. Despite the low incidence of infections in Norway, global spread requires an understanding of regional dissemination patterns.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim.<\/jats:bold>\n                    This study aimed to investigate the phenotypic and genotypic characteristics of CP-Pa isolates in Norway and molecular epidemiology by utilizing available metadata.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methodology.<\/jats:bold>\n                    The study collection comprised all verified CP-Pa isolated in Norway from 2006 to 2022 (\n                    <jats:italic>n<\/jats:italic>\n                    =67) obtained from clinical (75%;\n                    <jats:italic>n<\/jats:italic>\n                    =50) or screening samples (22%;\n                    <jats:italic>n<\/jats:italic>\n                    =15) or had no available information (3%;\n                    <jats:italic>n<\/jats:italic>\n                    =2). Phenotypic analyses included antimicrobial susceptibility testing against clinically relevant antipseudomonal antibiotics and comparative testing for carbapenemase production using three different methods (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    -CARBA, IMI\/IMD gradient test and Coris O.K.N.V.I RESIST-5). Whole-genome sequencing was performed to identify virulence factors, resistance determinants and genomic relatedness.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results.<\/jats:bold>\n                    The isolates were categorized as MDR (\n                    <jats:italic>n<\/jats:italic>\n                    =39) encoding Verona integron-encoded metallo-\n                    <jats:italic>\u03b2<\/jats:italic>\n                    -lactamase (VIM) (\n                    <jats:italic>n<\/jats:italic>\n                    =28), New Delhi metallo-\n                    <jats:italic>\u03b2<\/jats:italic>\n                    -lactamase (NDM) (\n                    <jats:italic>n<\/jats:italic>\n                    =6), imipenemase metallo-\n                    <jats:italic>\u03b2<\/jats:italic>\n                    -lactamase (IMP) (\n                    <jats:italic>n<\/jats:italic>\n                    =4) or Guiana extended spectrum metallo-\n                    <jats:italic>\u03b2<\/jats:italic>\n                    -lactamase (\n                    <jats:italic>n<\/jats:italic>\n                    =1) carbapenemases or extensively drug-resistant (XDR;\n                    <jats:italic>n=<\/jats:italic>\n                    28) encoding VIM (\n                    <jats:italic>n<\/jats:italic>\n                    =11), NDM (\n                    <jats:italic>n<\/jats:italic>\n                    =9) or IMP (\n                    <jats:italic>n<\/jats:italic>\n                    =8) carbapenemases. CP-Pa numbers ranged from 1 to 7 annually, peaking at 17 in 2022. Most isolates (\n                    <jats:italic>n<\/jats:italic>\n                    =64) were associated with international travel or hospitalization abroad. Phylogenetic analyses identified nine clusters of closely related genomes, with one suspected case of domestic patient-to-patient transmission. Among 21 detected sequence types, several were global high-risk clones, including ST235 (\n                    <jats:italic>n<\/jats:italic>\n                    =12), ST111 (\n                    <jats:italic>n<\/jats:italic>\n                    =9), ST773 (\n                    <jats:italic>n<\/jats:italic>\n                    =9), ST253 (\n                    <jats:italic>n<\/jats:italic>\n                    =3), ST357 (\n                    <jats:italic>n<\/jats:italic>\n                    =3), ST395 (\n                    <jats:italic>n<\/jats:italic>\n                    =3), ST823 (\n                    <jats:italic>n<\/jats:italic>\n                    =3), ST233 (\n                    <jats:italic>n<\/jats:italic>\n                    =2), ST654 (\n                    <jats:italic>n<\/jats:italic>\n                    =2), ST260 (\n                    <jats:italic>n<\/jats:italic>\n                    =1) and ST308 (\n                    <jats:italic>n<\/jats:italic>\n                    =1), covering 72% of the Norwegian isolates. ST1047 (IMP-1) and ST773 (NDM-1) were associated with Ukrainian war victims. Carbapenemase detection rates for phenotypic tests were 88% (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    -CARBA), 91% (IMI\/IMD) and 94% (Coris) in our collection.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    The study highlights the low incidence yet high genomic diversity of CP-Pa in Norway and the dominance of high-risk clones linked to imports, contributing to the high proportion of XDR.\n                  <\/jats:p>","DOI":"10.1099\/jmm.0.001944","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T08:17:13Z","timestamp":1736151433000},"source":"Crossref","is-referenced-by-count":9,"title":["Import of global high-risk clones is the primary driver of carbapenemase-producing Pseudomonas aeruginosa in Norway"],"prefix":"10.1099","volume":"74","author":[{"given":"Bj\u00f8rg 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