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Here, we determined fifteen SXT\/R391 ICEs carried by <jats:italic>Proteus<\/jats:italic> isolates from food (4.2%) and diarrhoea patients (17.3%). BLASTn searches against GenBank showed that the fifteen SXT\/R391 ICEs were closely related to that from different <jats:italic>Enterobacteriaceae<\/jats:italic> species, including <jats:italic>Proteus mirabilis<\/jats:italic>. Using core gene phylogenetic analysis, the fifteen SXT\/R391 ICEs were grouped into six distinct clusters, including a dominant cluster and three clusters that have not been previously reported in <jats:italic>Proteus<\/jats:italic> isolates. The SXT\/R391 ICEs shared a common structure with a set of conserved genes, five hotspots and two variable regions, which contained more foreign genes, including drug-resistance genes. Notably, a class A \u03b2-lactamase gene was identified in nine SXT\/R391 ICEs. Collectively, the ICE-carrying isolates carried resistance genes for 20 tested drugs. Six isolates were resistant to chloramphenicol, kanamycin, streptomycin, trimethoprim-sulfamethoxazole, sulfisoxazole and tetracycline, which are drug resistances commonly encoded by ICEs. Our results demonstrate abundant genetic diversity and multidrug resistance of the SXT\/R391 ICEs carried by <jats:italic>Proteus<\/jats:italic> isolates, which may have significance for public health. It is therefore necessary to continuously monitor the antimicrobial resistance and related mobile elements among <jats:italic>Proteus<\/jats:italic> isolates.<\/jats:p>","DOI":"10.1038\/srep37372","type":"journal-article","created":{"date-parts":[[2016,11,28]],"date-time":"2016-11-28T11:01:05Z","timestamp":1480330865000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["SXT\/R391 integrative and conjugative elements in Proteus species reveal abundant genetic diversity and multidrug resistance"],"prefix":"10.1038","volume":"6","author":[{"given":"Xinyue","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengcheng","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenpeng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoli","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Kan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duochun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,11,28]]},"reference":[{"key":"BFsrep37372_CR1","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.resmic.2004.01.012","volume":"155","author":"V Burrus","year":"2004","unstructured":"Burrus, V. & Waldor, M. K. Shaping bacterial genomes with integrative and conjugative elements. Research in microbiology 155, 376\u2013386, doi: 10.1016\/j.resmic.2004.01.012 (2004).","journal-title":"Research in microbiology"},{"key":"BFsrep37372_CR2","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.plasmid.2006.01.001","volume":"55","author":"V Burrus","year":"2006","unstructured":"Burrus, V., Marrero, J. & Waldor, M. K. The current ICE age: biology and evolution of SXT-related integrating conjugative elements. Plasmid 55, 173\u2013183, doi: 10.1016\/j.plasmid.2006.01.001 (2006).","journal-title":"Plasmid"},{"key":"BFsrep37372_CR3","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/j.1574-6968.2006.00452.x","volume":"264","author":"JT Pembroke","year":"2006","unstructured":"Pembroke, J. T. & Piterina, A. V. A novel ICE in the genome of Shewanella putrefaciens W3-18-1: comparison with the SXT\/R391 ICE-like elements. 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