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The present study aimed to investigate the prevalence and molecular epidemiology of\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    among 50\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    isolates causing bloodstream infections in cancer patients in Egypt, and to characterize their antimicrobial resistance profiles, carbapenemase production, and biofilm-forming capacity. Antimicrobial susceptibility testing, minimum inhibitory concentrations, multiplex PCR for carbapenemase genes, biofilm assays, and multilocus sequence typing (MLST) were performed. Two representative isolates underwent whole-genome sequencing (WGS) to determine the genetic context of\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    . All isolates exhibited multidrug-resistant or extensively drug-resistant phenotypes. Carbapenem resistance was detected in 80% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200940) of isolates, and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    was identified in 64% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200932), comprising 80% of carbapenem-resistant isolates. Strong biofilm formation was significantly associated with\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    carriage (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.0115). MLST analysis of a subset of\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    \u2013producing isolates (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910) revealed two sequence types among\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1-<\/jats:italic>\n                    <\/jats:sub>\n                    producing isolates: ST308 (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20096) and ST773 (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094). These findings indicate the dissemination of high-risk\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    clones ST308 and ST773 carrying\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    in Egypt. WGS showed chromosomal integration of\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    within integrative and conjugative elements (ICEs) containing IS91-family transposases and multiple additional resistance genes. However, the relatively small sample size and the limited number of isolates subjected to WGS may restrict the generalizability of these findings. The presence of\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>\n                      <jats:italic>NDM-1<\/jats:italic>\n                    <\/jats:sub>\n                    within mobile genetic platforms highlights the ongoing evolution and dissemination of CRPA in this clinical setting and calls for enhanced surveillance, as these lineages may act as reservoirs for the acquisition and dissemination of diverse antimicrobial resistance determinants via their putative ICE.\n                  <\/jats:p>","DOI":"10.1186\/s12866-026-05178-2","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:27:25Z","timestamp":1782124045000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emergence of blaNDM\u22121 in Pseudomonas aeruginosa ST308 and ST773 from bloodstream infections in Egypt"],"prefix":"10.1186","volume":"26","author":[{"given":"Asmaa","family":"AbdulHak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdallah H.","family":"Zedan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadir A.","family":"El-Mahallawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A","family":"Sayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai M.","family":"Zafer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"1","key":"5178_CR1","doi-asserted-by":"publisher","first-page":"296","DOI":"10.21608\/mid.2023.239527.1627","volume":"5","author":"AF Makled","year":"2024","unstructured":"Makled AF, Younes HEB, Ghonaim MM, Shaalan AK, El-Mahdy EES. 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Microb Biotechnol. 2024;17(1):1\u201315. https:\/\/doi.org\/10.1111\/1751-7915. .14408.","journal-title":"Microb Biotechnol"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-026-05178-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05178-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05178-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T09:44:17Z","timestamp":1782207857000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12866-026-05178-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5178"],"URL":"https:\/\/doi.org\/10.1186\/s12866-026-05178-2","relation":{},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"19 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received approval from the Safe Handling and Disposal of Chemicals and Biologicals committee at the Faculty of Pharmacy, Cairo University, Egypt (ML2836) and the local ethical committee at the Faculty of Pharmacy, Ahram Canadian University (REC1723). Additionally, the study protocol was approved by the institutional ethics committee of the National Cancer Institute, Cairo University (Protocol No.CP1912-60301). All bacterial isolates used in this study were obtained from routine clinical microbiology laboratory workflows. No direct patient contact occurred, and no identifiable patient information was accessed. Therefore, informed consent was formally waived by the relevant Institutional Review Boards, in accordance with Egyptian national regulations. All clinical data were anonymized prior to analysis to ensure patient confidentiality, and the study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"567"}}