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      Genome plasticity favours double chromosomal Tn 4401b- bla KPC-2 transposon insertion in the Pseudomonas aeruginosa ST235 clone

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          Abstract

          Background

          Pseudomonas aeruginosa Sequence Type 235 is a clone that possesses an extraordinary ability to acquire mobile genetic elements and has been associated with the spread of resistance genes, including genes that encode for carbapenemases. Here, we aim to characterize the genetic platforms involved in resistance dissemination in bla KPC-2 -positive P. aeruginosa ST235 in Colombia.

          Results

          In a prospective surveillance study of infections in adult patients attended in five ICUs in five distant cities in Colombia, 58 isolates of P. aeruginosa were recovered, of which, 27 (46.6%) were resistant to carbapenems. The molecular analysis showed that 6 (22.2%) and 4 (14.8%) isolates harboured the bla VIM and bla KPC-2 genes, respectively. The four bla KPC-2-positive isolates showed a similar PFGE pulsotype and belonged to ST235. Complete genome sequencing of a representative ST235 isolate shows a unique chromosomal contig of 7097.241 bp with eight different resistance genes identified and five transposons: a Tn 6162-like with ant(2″)-Ia, two Tn 402-like with ant(3″)-Ia and bla OXA-2 and two Tn 4401b with bla KPC-2. All transposons were inserted into the genomic islands. Interestingly, the two Tn 4401b copies harbouring bla KPC-2 were adjacently inserted into a new genomic island (PAGI-17) with traces of a replicative transposition process. This double insertion was probably driven by several structural changes within the chromosomal region containing PAGI-17 in the ST235 background.

          Conclusion

          This is the first report of a double Tn 4401b chromosomal insertion in P. aeruginosa, just within a new genomic island (PAGI-17). This finding indicates once again the great genomic plasticity of this microorganism .

          Electronic supplementary material

          The online version of this article (10.1186/s12866-019-1418-6) contains supplementary material, which is available to authorized users.

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          Most cited references41

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          The comprehensive antibiotic resistance database.

          The field of antibiotic drug discovery and the monitoring of new antibiotic resistance elements have yet to fully exploit the power of the genome revolution. Despite the fact that the first genomes sequenced of free living organisms were those of bacteria, there have been few specialized bioinformatic tools developed to mine the growing amount of genomic data associated with pathogens. In particular, there are few tools to study the genetics and genomics of antibiotic resistance and how it impacts bacterial populations, ecology, and the clinic. We have initiated development of such tools in the form of the Comprehensive Antibiotic Research Database (CARD; http://arpcard.mcmaster.ca). The CARD integrates disparate molecular and sequence data, provides a unique organizing principle in the form of the Antibiotic Resistance Ontology (ARO), and can quickly identify putative antibiotic resistance genes in new unannotated genome sequences. This unique platform provides an informatic tool that bridges antibiotic resistance concerns in health care, agriculture, and the environment.
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            Artemis: sequence visualization and annotation

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              Pseudomonas Aeruginosa: Resistance to the Max

              Pseudomonas aeruginosa is intrinsically resistant to a variety of antimicrobials and can develop resistance during anti-pseudomonal chemotherapy both of which compromise treatment of infections caused by this organism. Resistance to multiple classes of antimicrobials (multidrug resistance) in particular is increasingly common in P. aeruginosa, with a number of reports of pan-resistant isolates treatable with a single agent, colistin. Acquired resistance in this organism is multifactorial and attributable to chromosomal mutations and the acquisition of resistance genes via horizontal gene transfer. Mutational changes impacting resistance include upregulation of multidrug efflux systems to promote antimicrobial expulsion, derepression of ampC, AmpC alterations that expand the enzyme's substrate specificity (i.e., extended-spectrum AmpC), alterations to outer membrane permeability to limit antimicrobial entry and alterations to antimicrobial targets. Acquired mechanisms contributing to resistance in P. aeruginosa include β-lactamases, notably the extended-spectrum β-lactamases and the carbapenemases that hydrolyze most β-lactams, aminoglycoside-modifying enzymes, and 16S rRNA methylases that provide high-level pan-aminoglycoside resistance. The organism's propensity to grow in vivo as antimicrobial-tolerant biofilms and the occurrence of hypermutator strains that yield antimicrobial resistant mutants at higher frequency also compromise anti-pseudomonal chemotherapy. With limited therapeutic options and increasing resistance will the untreatable P. aeruginosa infection soon be upon us?
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                Author and article information

                Contributors
                djabril@unbosque.edu.co
                ramarquezo@gmail.com
                betsy2402@gmail.com
                jimo@utp.edu.co
                htunalcove@yahoo.com
                lore_rozo@yahoo.com
                niradiz@gmail.com
                catalinatovar@unisinu.edu.co
                chessanchez@gmail.com
                castellanosjaime@unbosque.edu.co
                yimagugo@utp.edu.co
                coordinacionlaboratoriohusj@gmail.com
                natashavanegas@yahoo.es
                57 1 6489000 , escobarjavier@unbosque.edu.co , javiesco21@yahoo.com
                Journal
                BMC Microbiol
                BMC Microbiol
                BMC Microbiology
                BioMed Central (London )
                1471-2180
                20 February 2019
                20 February 2019
                2019
                : 19
                : 45
                Affiliations
                [1 ]ISNI 0000 0004 1761 4447, GRID grid.412195.a, Bacterial Molecular Genetics Laboratory, , Universidad El Bosque, ; Carrera 9 N°131A-02, Bogotá D.C, Colombia
                [2 ]ISNI 0000 0001 2176 1069, GRID grid.412256.6, Grupo de Investigación en Enfermedades Infecciosas- GRIENI, Facultad de Ciencias de la Salud, , Universidad Tecnológica de Pereira, ; Pereira, Colombia
                [3 ]Hospital El Tunal E.S.E, Bogotá D.C, Colombia
                [4 ]ISNI 0000 0004 0486 624X, GRID grid.412885.2, Grupo de Genética y Biología Molecular, , Universidad de Cartagena, ; Cartagena, Colombia
                [5 ]GRID grid.441931.a, Grupo de Investigación en Enfermedades Tropicales y Resistencia Bacteriana, , Universidad del Sinú, ; Montería, Colombia
                [6 ]Hospital Universitario Departamental de Nariño, Pasto, Colombia
                [7 ]ISNI 0000 0001 0286 3748, GRID grid.10689.36, Grupo de Patogénesis Infecciosa, , Universidad Nacional de Colombia, ; Bogotá D.C, Colombia
                [8 ]ESE-Hospital Universitario San Jorge, Pereira, Colombia
                [9 ]ISNI 0000 0004 1936 7611, GRID grid.117476.2, The i3 institute, Faculty of Science University of Technology, ; Sydney, Australia
                Author information
                http://orcid.org/0000-0002-0432-6978
                Article
                1418
                10.1186/s12866-019-1418-6
                6381643
                30786858
                989852fc-5027-42a7-aa2b-1b66c686ff9e
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 December 2017
                : 12 February 2019
                Funding
                Funded by: Departamento Administrativo de Ciencia, Tecnología e Innovación (CO)
                Award ID: 1308-657-41107 and 1308-569-33463
                Award ID: 1308-657-41107
                Funded by: Universidad El Bosque
                Award ID: PCI63-2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Microbiology & Virology
                blakpc-2,pseudomonas aeruginosa,carbapenems,resistance,colombia,st235
                Microbiology & Virology
                blakpc-2, pseudomonas aeruginosa, carbapenems, resistance, colombia, st235

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