Abstract
We describe the transfer of bla(KPC-4) from Enterobacter cloacae to Serratia marcescens in a single patient. DNA sequencing revealed that KPC-4 was encoded on an IncL/M plasmid, pNE1280, closely related to pCTX-M360. Further analysis found that KPC-4 was encoded within a novel Tn4401 element (Tn4401f) containing a truncated tnpA and lacking tnpR, ISKpn7 left, and Tn4401 IRL-1, which are conserved in other Tn4401 transposons. This study highlights the continued evolution of Tn4401 transposons and movement to multiple plasmid backbones that results in acquisition by multiple species of Gram-negative bacilli.
Publication types
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Case Reports
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Research Support, N.I.H., Intramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use
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Coinfection
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DNA Transposable Elements*
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Enterobacter cloacae / drug effects
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Enterobacter cloacae / genetics*
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Enterobacter cloacae / isolation & purification
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Enterobacteriaceae Infections / drug therapy
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Enterobacteriaceae Infections / microbiology
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Fatal Outcome
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Female
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Gene Transfer, Horizontal*
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Humans
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Middle Aged
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Plasmids*
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Sequence Analysis, DNA
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Serratia Infections / drug therapy
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Serratia Infections / microbiology
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Serratia marcescens / drug effects
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Serratia marcescens / genetics*
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Serratia marcescens / isolation & purification
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beta-Lactam Resistance / genetics*
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beta-Lactamases / genetics
Substances
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Anti-Bacterial Agents
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DNA Transposable Elements
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beta-Lactamases