DOI: 10.1128/asmcr.00148-26 ISSN: 2996-2684

First report of an NDM-1- and KPC-3-co-producing Pluralibacter gergoviae isolate recovered from a hepatic abscess

Abdullah Kilic, Elizabeth L. Palavecino
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ABSTRACT

Background

Pluralibacter gergoviae (formerly Enterobacter gergoviae ) is an uncommon opportunistic pathogen increasingly recognized for its ability to acquire clinically significant antimicrobial resistance determinants, including carbapenemases. While isolates harboring either bla NDM or bla KPC have been reported, the co-existence of both carbapenemase genes within a single clinical P. gergoviae isolate has not previously been described. We report the first clinical isolate of P. gergoviae co-producing NDM-1 and KPC-3 recovered from a patient with a hepatic abscess.

Case Summary

A 58-year-old man with poorly controlled diabetes mellitus and cirrhosis presented with septic shock secondary to a hepatic abscess requiring percutaneous drainage. Following transfer to a tertiary care center, culture of drain fluid grew carbapenem-resistant P. gergoviae . Antimicrobial susceptibility testing demonstrated resistance to multiple β-lactam agents, including carbapenems and novel β-lactam/β-lactamase inhibitor combinations. The patient was treated with ampicillin-sulbactam and ciprofloxacin, resulting in clinical improvement and radiographic resolution of the abscess. Whole-genome sequencing identified co-existing bla NDM-1 and bla KPC-3 located on separate plasmids, along with additional resistance determinants conferring an extensively drug-resistant genotype.

Conclusion

This report documents the first known clinical P. gergoviae isolate co-harboring bla NDM-1 and bla KPC-3 in the United States. The presence of multiple plasmid-mediated carbapenemases highlights the remarkable genetic adaptability of this emerging pathogen and underscores its potential role as a reservoir for high-risk antimicrobial resistance genes. Increased awareness, comprehensive susceptibility testing, and genomic surveillance are essential to monitor the emergence and dissemination of multidrug-resistant P. gergoviae strains.

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