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Whereas some resistance mechanisms are conferred by uptake of resistance genes, others evolve by mutation. In this study, IS\n                    <jats:italic>256<\/jats:italic>\n                    has been shown to play a role, e.g., in\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    strains displaying intermediate resistance to vancomycin (VISA). To characterize the IS\n                    <jats:italic>256<\/jats:italic>\n                    insertion sites in the genomes of two closely related sequence type 247 (ST247) VISA strains, all insertions were mapped in both VISA and a susceptible control strain. The results showed that the three ST247 strains contained the highest number so far of IS\n                    <jats:italic>256<\/jats:italic>\n                    insertions for all sequenced\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    strains. Furthermore, in contrast to the case with the other IS elements in these genomes, the IS\n                    <jats:italic>256<\/jats:italic>\n                    insertion sites were not identical in the closely related strains, indicating a high transposition frequency of IS\n                    <jats:italic>256<\/jats:italic>\n                    . When IS\n                    <jats:italic>256<\/jats:italic>\n                    was introduced into a laboratory strain which was then cultured in the presence of antibiotics, it was possible to isolate small-colony variants (SCVs) that possessed IS\n                    <jats:italic>256<\/jats:italic>\n                    insertions in\n                    <jats:italic>guaA<\/jats:italic>\n                    and\n                    <jats:italic>hemY<\/jats:italic>\n                    that displayed increased resistance to vancomycin and aminoglycosides, respectively. For these clones, a very rapid reversion to the wild type that resembled the fast reversion of clinical SCVs was observed. The reversion was caused by excision of IS\n                    <jats:italic>256<\/jats:italic>\n                    in a small number of fast-growing clones that quickly outcompeted the SCVs in broth cultures. In conclusion, the presence of IS\n                    <jats:italic>256<\/jats:italic>\n                    confers a strong genomic plasticity that is useful for adaptation to antibiotic stress.\n                  <\/jats:p>","DOI":"10.1128\/aac.00144-17","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T20:30:26Z","timestamp":1496694626000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":28,"title":["Influence of IS\n                    <i>256<\/i>\n                    on Genome Variability and Formation of Small-Colony Variants in Staphylococcus aureus"],"prefix":"10.1128","volume":"61","author":[{"given":"Franziska","family":"Kleinert","sequence":"first","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9195-0276","authenticated-orcid":false,"given":"Ren\u00e9","family":"Kallies","sequence":"additional","affiliation":[{"name":"Helmholtz Centre for Environmental Research\u2014UFZ, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hort","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annegret","family":"Zweynert","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Szekat","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Nagel","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Bierbaum","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","first-page":"3031","article-title":"Detection and characterization of IS256, an insertion sequence in Staphylococcus aureus","volume":"133","author":"Lyon BR","year":"1987","unstructured":"Lyon BR GillespieMT SkurrayRA. 1987. 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