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Updated: May 7, 2025

Author Spotlight: Understanding and Detecting Environmental Antimicrobial Resistance by Combining Culture-Based Techniques and Genomics
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Developing a framework for tracking antimicrobial resistance gene movement in a persistent environmental reservoir.

Amy J Mathers1,2, Thomas J X Li1,3, Qijun He3

  • 1Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA USA.

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Mobile genetic elements drive antibiotic resistance. A new model shows the blaKPC gene frequently moves between plasmids and bacterial chromosomes in hospital drains, highlighting gene transmission dynamics.

Keywords:
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Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Mobile genetic elements, such as plasmids, are critical drivers of antibiotic resistance.
  • The carbapenemase gene blaKPC is a significant threat in healthcare settings, contributing to carbapenem resistance.

Purpose of the Study:

  • To reconstruct bacterial genomes and plasmids to understand the evolution and movement of the blaKPC gene over five years in hospital drains.
  • To develop and validate a novel mathematical approach for assessing the directional movement of antimicrobial resistance genes.

Main Methods:

  • Complete bacterial genome and plasmid assemblies were reconstructed from 82 isolates collected over five years.
  • A novel mathematical approach, the 'Composite-Sample Complex', was developed to model the directional movement of antimicrobial resistance genes, considering both plasmid and chromosomal DNA.
  • The model was validated to identify gene donors and recipients and assess transposition events.

Main Results:

  • 14 unique strains from 10 species carrying blaKPC were identified, associated with 113 plasmids across 16 replicon types.
  • The Composite-Sample Complex model demonstrated frequent transposition of blaKPC between plasmids and integration into the bacterial chromosome within specific hospital drains.
  • The study highlights the dynamic nature of antimicrobial resistance gene mobilization in a confined environment.

Conclusions:

  • Mobile genetic elements, particularly plasmids, facilitate the rapid dissemination of critical antibiotic resistance genes like blaKPC.
  • The Composite-Sample Complex provides a robust framework for understanding the complex dynamics of antimicrobial resistance gene transfer.
  • This research offers insights into the evolution and spread of antibiotic resistance in hospital environments, informing infection control strategies.