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multiple antimicrobials, including tigecycline. Here we report the first identification of\n                    <jats:italic>tmexCD\u2010toprJ\u2010<\/jats:italic>\n                    harbouring\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    <\/jats:styled-content>\n                    strain KAM950, isolated from hospital sewage in Japan in 2022. The isolate exhibited reduced susceptibility to tigecycline and carbapenems. Complete genome sequence analysis showed that KAM950 belongs to sequence type 244 (ST244) according to multilocus sequence typing, an internationally recognised epidemic clone, and harbours multiple antimicrobial resistance genes, including the\n                    <jats:italic>tmexCD\u2010toprJ<\/jats:italic>\n                    variant,\n                    <jats:italic>tmexC6D6\u2010toprJ1b<\/jats:italic>\n                    . Notably, the\n                    <jats:italic>tmexC6D6\u2010toprJ1b<\/jats:italic>\n                    gene cluster was located on the chromosome, adjacent to the transcriptional regulator gene\n                    <jats:italic>tnfxB6<\/jats:italic>\n                    and an IS\n                    <jats:italic>5<\/jats:italic>\n                    \/IS\n                    <jats:italic>1182<\/jats:italic>\n                    family transposase gene. Furthermore, an IS\n                    <jats:italic>4<\/jats:italic>\n                    \u2010mediated disruption of the porin gene\n                    <jats:italic>oprD<\/jats:italic>\n                    was observed, potentially contributing to carbapenem resistance. BLASTn analysis revealed that the IS\n                    <jats:italic>5<\/jats:italic>\n                    \/IS\n                    <jats:italic>1182\u2010tnfxB6\u2010tmexC6D6\u2010toprJ1b<\/jats:italic>\n                    gene cluster present in both chromosomal and plasmid sequences among the order\n                    <jats:italic>Pseudomonadaceae<\/jats:italic>\n                    , indicating potential horizontal gene transfer of\n                    <jats:italic>tnfxB6\u2010tmexC6D6\u2010toprJ1b<\/jats:italic>\n                    mediated by IS\n                    <jats:italic>5<\/jats:italic>\n                    \/IS\n                    <jats:italic>1182<\/jats:italic>\n                    . Our findings highlight the ongoing expansion of variant diversity and geographic spread of\n                    <jats:italic>tmexCD\u2010toprJ<\/jats:italic>\n                    \u2010like gene clusters, and underscore the importance of genomic surveillance for emerging antimicrobial resistance determinants in both clinical and environmental settings.\n                  <\/jats:p>","DOI":"10.1111\/1758-2229.70275","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:00:56Z","timestamp":1772989256000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emergence of Tigecycline\u2010Resistant\n                    <i>Pseudomonas aeruginosa<\/i>\n                    Harbouring\n                    <i>tmexC6D6<\/i>\n                    \u2010\n                    <i>toprJ1b<\/i>\n                    From Hospital Sewage in Japan"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3187-2090","authenticated-orcid":false,"given":"Shotaro","family":"Maehana","sequence":"first","affiliation":[{"name":"Department of Microbiology School of Allied Health Sciences, Kitasato University  Kanagawa Japan"},{"name":"Department of Environmental Microbiology Graduate School of Medical Sciences, Kitasato University  Kanagawa Japan"},{"name":"Regenerative Medicine and Cell Design Research Facility  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8975-2193","authenticated-orcid":false,"given":"Masato","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Antimicrobial Resistance Research Center, Japan Institute for Health Security  Tokyo 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