1887

Abstract

Carbapenems are considered the last-resort antibiotics to treat infections caused by multidrug-resistant Gram-negative bacilli. The carbapenemase (KPC) enzyme hydrolyses β-lactam antibiotics including the carbapenems. KPC has been detected worldwide in and isolates associated with transposon Tn commonly located in plasmids. has become an important multidrug-resistant nosocomial pathogen. KPC-producing has been reported to date only in Puerto Rico. The objective of this study was to determine the whole genomic sequence of a KPC-producing in order to (i) define its allelic diversity, (ii) identify the location and genetic environment of the and (iii) detect additional mechanisms of antimicrobial resistance. Next-generation sequencing, Southern blot, PFGE, multilocus sequence typing and bioinformatics analysis were performed. The organism was assigned to the international ST2 clone. The was identified on a novel truncated version of Tn (tentatively named Tn), located in the chromosome within an IncA/C plasmid fragment derived from an , probably owing to insertion sequence IS. A chromosomally located truncated Tn transposon harbouring a was found in a novel genetic environment within an antimicrobial resistance cluster. Additional resistance mechanisms included efflux pumps, non-β-lactam antibiotic inactivating enzymes within and outside a resistance island, two class 1 integrons, In and the novel In, as well as mutations in the topoisomerase and DNA gyrase genes which confer resistance to quinolones. The presence of the in an already globally disseminated ST2 presents a serious threat of further dissemination.

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2016-08-01
2020-08-13
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