title: Persistence and epidemic propagation of a Pseudomonas aeruginosa sequence type 235 clone harboring an IS26 composite transposon carrying the blaIMP-1 integron in Hiroshima, Japan, 2005 to 2012.
abstract: A 9-year surveillance for multidrug-resistant (MDR) Pseudomonas aeruginosa in the Hiroshima region showed that the number of isolates harboring the metallo-β-lactamase gene bla(IMP-1) abruptly increased after 2004, recorded the highest peak in 2006, and showed a tendency to decline afterwards, indicating a history of an epidemic. PCR mapping of the variable regions of the integrons showed that this epidemic was caused by the clonal persistence and propagation of an MDR P. aeruginosa strain harboring the bla(IMP-1) gene and an aminoglycoside 6'-N-acetyltransferase gene, aac(6')-Iae in a class I integron (In113), whose integrase gene intl1 was disrupted by an IS26 insertion. Sequence analysis of the representative strain PA058447 resistance element containing the In113-derived gene cassette array showed that the element forms an IS26 transposon embedded in the chromosome. It has a Tn21 backbone and is composed of two segments sandwiched by three IS26s. In Japan, clonal nationwide expansion of an MDR P. aeruginosa NCGM2.S1 harboring chromosomally encoded In113 with intact intl1 is reported. Multilocus sequence typing and genomic comparison strongly suggest that PA058447 and NCGM2.S1 belong to the same clonal lineage. Moreover, the structures of the resistance element in the two strains are very similar, but the sites of insertion into the chromosome are different. Based on tagging information of the IS26 present in both resistance elements, we suggest that the MDR P. aeruginosa clone causing the epidemic in Hiroshima for the past 9 years originated from a common ancestor genome of PA058447 and NCGM2.S1 through an IS26 insertion into intl1 of In113 and through IS26-mediated genomic rearrangements.
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Department of Surgery, Hiroshima University, Hiroshima, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Shizuo
authors.initials: S
authors.lastname: Kayama
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Department of Urology, National Hospital Organization Kure Medical Center, Kure City, Hiroshima, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Kouda
authors.affiliation: Division of Microbial Genomics, Department of Genomics and Bioenvironmental Science, Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan Division of Microbiology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: Yoshitoshi
authors.initials: Y
authors.lastname: Ogura
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Department of Urology, Chugoku Rousai Hospital, Kure, Hiroshima, Japan.
authors.forename: Kanao
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Shigemoto
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Department of Surgery, Hiroshima University, Hiroshima, Japan.
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Shimada
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Department of Surgery, Hiroshima University, Hiroshima, Japan.
authors.forename: Raita
authors.initials: R
authors.lastname: Yano
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Junzo
authors.initials: J
authors.lastname: Hisatsune
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Kato
authors.affiliation: Division of Microbial Genomics, Department of Genomics and Bioenvironmental Science, Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan Division of Microbiology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Surgery, Hiroshima University, Hiroshima, Japan.
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
authors.affiliation: Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan Department of Bacteriology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan sugai@hiroshima-u.ac.jp.
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Sugai
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D032023:Integrons / Q000235:genetics; D007564:Japan; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases