Integrons and insertion sequence common region 1 (ISCR1) of carbapenem-non-susceptible Gram-negative bacilli in fecal specimens from 5000 patients in southern China.

Highlights • 5000 fecal survey samples from inpatients prospectively and consecutively collected between July 1 and December 30, 2013. • Different genetic elements detected: integrons, insertion sequence common region 1 (IS CR1), complex class 1 integrons. • 389 carbapenem-non-susceptible strains from 5000 fecal specimens. • One novel gene cassette array was found in 205 class 1 integron–positive isolates. • Two different previously unreported complex class 1 integron-positive strains were isolated. Abstract The integrons and insertion sequence common region 1 (IS CR1) of 329 carbapenem-non-susceptible Gram-negative bacilli, excluding 60 Stenotrophomonas maltophilia strains, in fecal specimens from 5000 patients in southern China were studied. A total of 205 (62.3%) class 1 integron-positive strains and 126 (61.5%) gene-cassette-positive strains were detected, and 44 types of gene-cassette arrays were found, including 8 types described for the first time in the corresponding species and one gene cassette originally detected in integrons, a putative helicase. A total of 9 types of 21 IS CR1 -linked resistance gene regions in 35 IS CR 1-positive bacilli and 2 previously unreported types of complex class 1 integrons were detected. All strains were extensively drug-resistant. Class 1 integrons and IS CR1 were widely disseminated and these structures carried various resistance genes, which were closely associated with mechanisms of multidrug resistance, including carbapenem resistance. [ABSTRACT FROM AUTHOR]