Mobilisation of plasmid-me diate d bla(VEB-1) gene cassette into distinct genomic islands of Proteus mirabilis after ceftazidime exposure

Objectives: We sought to integrate a VEB-1-encoding gene cassette into the integron of the MDR region of genomic islands (GIs) harboured by Proteus mirabilis strains after antibiotic exposure. Methods: An IncP1 plasmid from Achromobacter xylosoxidans carrying the cassette array dfrA14-bla(VEB-1)-aadB was introduced by conjugation into five strains of P. mirabilis: PmBRI, PmABB, PmSCO and Pm2CHAMA harbouring Salmonella GI 1 and PmESC harbouring Proteus GI 1. Circular intermediates of the cassettes were amplified by PCR. bla(VEB)-harbouring P. mirabilis were exposed to increasing concentrations of ceftazidime each day. Presence of bla(VEB-1) in the GI was assessed by PCR. The complete MDR regions were mapped and sequenced in positive clones. Results: Circular intermediates were detected for dfrA14 and bla(VEB-1)-aadB and dfrA14-bla(VEB-1)-aadB cassettes arrays in A. xylosoxidans, and for aadA2 in P. mirabilis. Insertion of bla(VEB-1) into the GIs occurred under ceftazidime pressure. In all cases, the three cassettes from IncP1 were integrated. They replaced the cassette array of PmBRI, PmABB and PmSCO in which floRc, tet(A)G and bla(PSE-1) were conserved, whereas they replaced an integron and the IS26-flanked region in Pm2CHAMA. In PmESC, they only replaced aadB, with aadA2 being conserved. bla(VEB-1) integration occurred just after conjugation for Pm2CHAMA but required ceftazidime exposure for the other strains. Conclusion: Homologous recombination of gene cassettes conferring resistance to clinically important antibiotics may occur under antibiotic pressure between an integron located on a plasmid and a coresident GI. This feature participates in the acquisition, maintenance and spread of antibiotic resistance genes. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.