Simultaneous three Enterobacteriaceae with different -encoding plasmids in a patient transferred from mainland China to Taiwan.

New-Delhi metallo-β-lactamase1 (NDM-1) are increasing worldwide. Herein, we describe a single patient who carried three unusual NDM-1 carbapenem-resistant yielded from a urine specimen and and from stool specimens. For , its NDM-1-encoding plasmid was pKP04NDM with a size of ~54 kb replicons with an IncN backbone. For , its -encoding plasmid was pNDM-BTR with a size of ~59.6 kb and belonged to IncN. For , its main -encoding plasmid was pIMP-HK1500, and the NDM-1 gene was obtained from a part of pNDM-BTR (8439 bp). These three clinical strains are reported for the first time and are assumed to be imported from mainland China to Taiwan. The three different plasmids were never reported in and before. Owing to their associated multidrug resistance, appropriate measures of periodic, targeted surveillance, and development of new antimicrobial agents are urgently needed.