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This case presents the clinical and genomic aspects of a rare and multidrug-resistant Pseudomonas guariconensis isolate carrying bla VIM-2 and highlights the need for heightened awareness in healthcare facilities. A 63-year-old woman underwent surgery for the diagnosis of a paraspinal abscess and infectious spondylitis. During hospitalization, the patient was diagnosed with heart failure exacerbation. The patient had no symptoms of urinary tract infection and met the criteria for asymptomatic bacteriuria. In urine culture, colonies of the organism grew >10 5 CFU/mL on blood agar and on MacConkey agar. The Bruker Biotyper mass spectrometry showed P. guariconensis. Based on the 16S rRNA gene sequence showed that a 99.79 % match with as P. guariconensis LMG 27394 T . The average nucleotide identity with P. guariconensis LMG 27394 T was 91.53 %. Antimicrobial susceptibility testing showed that the isolate was not susceptible to most of the antibiotics. Antimicrobial resistance genes identified were aph(6)-Id, aph(3″)-Ib, aac(6')-Ib3, aac(3)-If, gyrA mutation (T83I) and bla VIM-2 ., Competing Interests: Declaration of competing interest Yoon C and Lee Y declare no potential conflicts of interest relevant to the publication of this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)