In mouse infection experiments, strain VP1434 (<i>tdh<sup>-</sup>/trh<sup>+</sup></i> ) exhibited significantly higher lethality than environmental isolates (<i>tdh<sup>-</sup>/trh<sup>-</sup></i> ), suggesting TRH plays a significant role in pathogenicity even in the absence of TDH.<h4>Conclusion</h4>This first report of <i>bla</i> <sub>NDM-1</sub>-positive clinical <i>V. The gene discussed is TDH; the disease is infection.