Fatal sepsis caused by multidrug-resistant Bacteroides fragilis containing a cfiA gene and an upstream insertion sequence element in Japan

Here we report a case of fatal sepsis stemming from an intra-abdominal infection caused by a Bacteroides fragilis strain containing a cfiA gene and insertion sequence (IS) element. Next-generation whole-genome sequencing indicated the presence of cfiA4, emrG, and emrF. The PCR indicated the presence of an IS element upstream of cifA4. Although carbapenem-resistant