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A carbapenem-resistant  Citrobacter freundii  strain WCHCF65 was recovered from hospital sewage and was characterized by genome sequencing and conjugation experiments. The strain carried nine genes encoding β-lactamases including two carbapenemase genes,  bla  NDM-1  and  bla  KPC-2 .  bla  NDM-1  was carried on an IncX3 plasmid, which was identical to a plasmid found in a local  Escherichia coli , suggesting interspecies horizontal transfer.  bla  KPC-2  was bracketed by two copies of insertion sequence IS Kpn19 , which could form a composite transposon with the potential to mobilize  bla  KPC-2 , on a new type of plasmid. The coexistence of  bla  NDM-1  and  bla  KPC-2  conferred higher levels of resistance to carbapenems compared with  bla  NDM-1  or  bla  KPC-2  alone. The coexistence of these carbapenemase genes, on two different plasmids, in one strain may allow new genetic platforms to be generated to mediate their spread.

Citrobacter freundii carrying blaKPC-2 and blaNDM-1: characterization by whole genome sequencing