First Report of bla VIM-4- and mcr-9-Coharboring Enterobacter Species Isolated from a Pediatric Patient.

An Enterobacter hormaechei isolate harboring bla VIM-4 and mcr-9 was recovered from a pediatric patient in a U.S. hospital. The bla VIM-4 and mcr-9 genes are carried on the same IncH12 plasmid, pME-1a. The isolate tested susceptible to colistin, without observed induction of colistin resistance. The mcr-9 gene is located between two insertion elements, IS903 and IS1, but lacks the downstream regulatory genes (qseC and qseB) found in other isolates that harbor mcr-9 IMPORTANCE We describe the complete genome assembly and sequence of a clinical Enterobacter isolate harboring both bla VIM-4 and mcr-9 recovered from a pediatric patient in the United States with a history of travel to Egypt. Moreover, to the best of our knowledge, this is the first report of an Enterobacter isolate harboring both bla VIM-4 and mcr-9 from the United States. The bla VIM-4 and mcr-9 genes are carried on the same IncH12 plasmid, pME-1a. The isolate tested susceptible to colistin, without observed induction of colistin resistance. The mcr-9 gene is located between two insertion elements, IS903 and IS1, but lacks the downstream regulatory genes (qseC and qseB) found in other isolates that harbor mcr-9.