Affiliation:
1. Nosocomial Infections, National Microbiology Laboratory, Health Canada, Winnipeg, Manitoba
2. Mount Sinai Hospital
3. The Vancouver General Hospital, Vancouver, British Columbia, Canada
4. University Health Network, Toronto, Ontario
5. Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Paris, France
Abstract
ABSTRACT
A major outbreak involving an
Escherichia coli
strain that was resistant to expanded-spectrum cephalosporins occurred in Toronto and surrounding regions in 2000 to 2002. We report the complete sequence of a plasmid, pC15-1a, that was found associated with the outbreak strain. Plasmid pC15-1a is a circular molecule of 92,353 bp consisting of two distinct regions. The first is a 64-kb region that is essentially homologous to the non-R-determinant region of plasmid R100 except for several point mutations, a few small insertions and deletions, and the absence of Tn
10
. The second is a 28.4-kb multidrug resistance region (MDR) that has replaced the R-determinant region of the R100 progenitor and consists mostly of transposons or partial transposons and five copies of the insertion element IS
26
. All drug resistance genes found in pC15-1a, including the beta-lactamase genes
bla
CTX-M-15
,
bla
OXA-1
, and
bla
TEM-1
, the tetracycline resistance gene
tetA
, and aminoglycoside resistance genes
aac
(
6
′)-
Ib
and
aac
(
3
)
-II
, are located in the MDR. The
bla
CTX-M-15
gene was found downstream of IS
Ecp1
as part of a transposition unit, as determined from the surrounding sequence. Examination of the plasmids from CTX-M-15-harboring strains isolated from hospitals across Canada showed that pC15-1a was found in several strains isolated from a site in western Canada. Comparison of pC15-1a and pCTX15, found in an
E. coli
strain isolated in India in 1999, revealed that the plasmids had several features in common, including an R100 backbone and several of the resistance genes, including
bla
CTX-M-15
,
bla
TEM-1
,
bla
OXA-1
,
tetA
, and
aac
(
6
′)
-Ib
.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
305 articles.
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