28Carbapenemases inactivate most ÎČ-lactam antibiotics, including carbapenems and have 29 been frequently reported among Enterobacteriaceae, Acinetobacter spp. and 30 Pseudomonas spp. Traditionally, the horizontal gene transfer of carbapenemase-31 encoding genes (CEGs) has been linked to plasmids. However, given that integrative and 32 conjugative elements (ICEs) are possibly the most abundant conjugative elements 33 among prokaryotes, we conducted an in silico analysis to ascertain the likely role of ICEs 34 in the spread of CEGs among all bacterial genomes. We detected 7457 CEGs, of which 35 224 were located within putative ICEs among several clinically-relevant bacterial species 36 (including Klebsiella pneumoniae, Escherichia coli, Citrobacter freundii, Enterobacter 37 hormaechei and Pseudomonas aeruginosa). Most CEGs detected within ICEs belong to 38 the KPC, IMP and NDM families and different mechanisms were likely responsible for 39 acquisition of these genes. The majority of CEG-bearing ICEs belong to the MPFT, MPFF, 40 MPFG and MPFI classes and often encode additional adaptive traits such as resistance to 41 other antibiotics (e.g. aminoglycosides and fluoroquinolones), metal and biocide 42 tolerance and bacteriocin production. This study provides a snapshot of the different 43 CEGs associated with ICEs among all bacterial genomes and sheds light on the 44 underappreciated contribution of ICEs to the spread of carbapenem resistance globally.