Novel type of Carbapenem-hydrolyzing Oxacillinase on resistance plasmid Inc A/C2 conferring multi-drug resistance to Citrobacter freundii.

In this study we aim to describe a discrepancy which occurred when analyzing a carbapenem resistant C. freundii collected under a routine screening in an Israeli hospital. The isolate showed MIC of 2 mg/L to Meropenem with negative PCR results for any of the known carbapenem genes. Surprisingly, the isolate showed positive Imipenem hydrolysis accompanied by negative results for OXA-48 like by lateral flow. In order to fully understand the resulting discrepancies the isolate was sequences using both Illumina and Oxford Nanopore Technologies (ONT) methods to obtain a full genome.