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Starting in 2022, Latvia and Lithuania experienced outbreaks of bla OXA-48-carrying Klebsiella pneumoniae in their healthcare systems. Different K. pneumoniae sequence types (STs) were involved in both countries, mainly ST147 in Latvia, and ST392 (part of clonal group CG147), ST395 and ST45 in Lithuania [1]. Long-read sequencing of one ST392 isolate in Lithuania and three ST147 isolates in Latvia identified an IncHI1B(pNDM-MAR) mosaic plasmid carrying both resistance (bla OXA-48) and virulence genes (aerobactin operon, iucABCD, iutA). To determine the extent of this plasmid's spread, the European Centre for Disease Prevention and Control (ECDC) initiated a cross-border outbreak investigation supported by the European Union (EU) reference laboratory for public health in the field of antimicrobial resistance in bacteria (EURL-PH-AMR).