title: Integration of the blaNDM-1 carbapenemase gene into Proteus genomic island 1 (PGI1-PmPEL) in a Proteus mirabilis clinical isolate.
abstract: OBJECTIVE
  To decipher the mechanisms and their associated genetic determinants responsible for β-lactam resistance in a Proteus mirabilis clinical isolate.
  
  
  METHODS
  The entire genetic structure surrounding the β-lactam resistance genes was characterized by PCR, gene walking and DNA sequencing.
  
  
  RESULTS
  Genes encoding the carbapenemase NDM-1 and the ESBL VEB-6 were located in a 38.5 kb MDR structure, which itself was inserted into a new variant of the Proteus genomic island 1 (PGI1). This new PGI1-PmPEL variant of 64.4 kb was chromosomally located, as an external circular form in the P. mirabilis isolate, suggesting potential mobility.
  
  
  CONCLUSIONS
  This is the first known description of the bla(NDM-1) gene in a genomic island structure, which might further enhance the spread of the bla(NDM-1) carbapenemase gene among enteric pathogens.
authors.affiliation: INSERM U914 'Emerging Resistance to Antibiotics', Faculté de Médecine et Université Paris Sud, K.-Bicêtre, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Girlich
authors.affiliation: INSERM U914 'Emerging Resistance to Antibiotics', Faculté de Médecine et Université Paris Sud, K.-Bicêtre, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Dortet
authors.affiliation: INSERM U914 'Emerging Resistance to Antibiotics', Faculté de Médecine et Université Paris Sud, K.-Bicêtre, France Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.affiliation: INSERM U914 'Emerging Resistance to Antibiotics', Faculté de Médecine et Université Paris Sud, K.-Bicêtre, France Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland patrice.nordmann@unifr.ch.
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D016386:Chromosome Walking; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D023061:Gene Order; D005798:Genes, Bacterial; D044404:Genomic Islands; D006801:Humans; D020071:Interspersed Repetitive Sequences; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011512:Proteus Infections / Q000382:microbiology; D011513:Proteus mirabilis / Q000201:enzymology* / Q000235:genetics* / Q000302:isolation & purification; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D004269:DNA, Bacterial; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1
keywords: NDM-1; P. mirabilis; VEB-6; carbapenem resistance; genomic island SGI1