Insertion Sequence IS26 Reorganizes Plasmids in Clinically Isolated Multidrug-Resistant Bacteria by Replicative Transposition

摘要: ABSTRACT Carbapenemase-producing Enterobacteriaceae (CPE), which are resistant to most or all known antibiotics, constitute a global threat public health. Transposable elements often associated with antibiotic resistance determinants, suggesting role in the emergence of resistance. One insertion sequence, IS 26 , is frequently but its remains unclear. We have analyzed genomic contexts 70 2 6 copies several clinical and surveillance CPE isolates from National Institutes Health Clinical Center. used target site duplications their patterns as guides found that large fraction plasmid reorganizations result replicative transpositions, including replicon fusions, DNA inversions, deletions. Replicative transposition could also be inferred for transposon Tn 4401 harbors carbapenemase bla KPC gene. Thus, important ongoing reorganization plasmids carrying multidrug-resistant an observation carries substantial epidemiological implications understanding how such extreme drug phenotypes evolve. IMPORTANCE Although reported reside isolates, characteristic hallmark transposition, duplication (TSD), generally not observed, raising questions about mode . The previous cointegrate formation during implies transposes via mechanism. other possible outcome inversion deletion, when occurs intramolecularly, this would generate specific TSD pattern might serve supporting evidence numerous examples we present here demonstrate by many mobile (including ), prevalent results significant reorganization. This study provides method trace evolution based on patterns.