Piperacillin/tazobactam resistance in a clinical isolate of Escherichia coli due to IS26-mediated amplification of blaTEM-1B

Alasdair Hubbard, Jenifer Mason, Paul Roberts, Christopher Parry, Caroline Corless, Jon van Aartsen, Alex Howard, Issra Bulgasim, Alice Fraser, Emily Adams, Adam Roberts, Thomas Edwards

Research output: Contribution to journalArticlepeer-review

62 Citations (Scopus)

Abstract

A phenotype of Escherichia coli and Klebsiella pneumoniae, resistant to piperacillin/tazobactam (TZP) but susceptible to carbapenems and 3rd generation cephalosporins, has emerged. The resistance mechanism associated with this phenotype has been identified as hyperproduction of the β-lactamase TEM. However, the mechanism of hyperproduction due to gene amplification is not well understood. Here we report a mechanism of gene amplification due to a translocatable unit (TU) excising from an IS26-flanked composite transposon, Tn6762, which harbours blaTEM-1B. The TU re-inserts into the chromosome adjacent to IS26 and forms a tandem array of TUs, which increases the copy number of blaTEM-1B, leading to TEM-1B hyperproduction and TZP resistance. Despite a significant increase in blaTEM-1B copy number, the TZP-resistant isolate does not incur a fitness cost compared to the TZP-susceptible ancestor. This mechanism of amplification of blaTEM-1B is an important consideration when using genomic data to predict susceptibility to TZP.

Original languageEnglish
Article number4915
Pages (from-to)4915
JournalNature Communications
Volume11
Issue number1
DOIs
Publication statusPublished - 1 Oct 2020

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