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Pulsed-field gel electrophoresis of SpeI-, XbaI-, or HpaI-digested genomic DNAs from the isolates revealed that clonal expansion of a\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            strain designated IMCJ2.S1 had occurred in the ward. This strain possessed broad-spectrum resistance to aminoglycosides, \u03b2-lactams, fluoroquinolones, tetracyclines, sulfonamides, and chlorhexidine. Strain IMCJ2.S1 showed a level of resistance to some kinds of disinfectants similar to that of a control strain of\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            , ATCC 27853. IMCJ2.S1 contained a novel class 1 integron, In113, in the chromosome but not on a plasmid. In113 contains an array of three gene cassettes of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>IMP-1<\/jats:sub>\n            , a novel aminoglycoside resistance gene, and the\n            <jats:italic>aadA1<\/jats:italic>\n            gene. The aminoglycoside resistance gene, designated\n            <jats:italic>aac(6\u2032)-Iae<\/jats:italic>\n            , encoded a 183-amino-acid protein that shared 57.1% identity with AAC(6\u2032)-Iq. Recombinant AAC(6\u2032)-Iae protein showed aminoglycoside 6\u2032-\n            <jats:italic>N<\/jats:italic>\n            -acetyltransferase activity by thin-layer chromatography.\n            <jats:italic>Escherichia coli<\/jats:italic>\n            expressing exogenous\n            <jats:italic>aac(6\u2032)-Iae<\/jats:italic>\n            showed resistance to amikacin, dibekacin, isepamicin, kanamycin, netilmicin, sisomicin, and tobramycin but not to arbekacin, gentamicins, or streptomycin. Alterations of\n            <jats:italic>gyrA<\/jats:italic>\n            and\n            <jats:italic>parC<\/jats:italic>\n            at the amino acid sequence level were detected in IMCJ2.S1, suggesting that such mutations confer the resistance to fluoroquinolones observed for this strain. These results indicate that\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            IMCJ2.S1 has developed multidrug resistance by acquiring resistance determinants, including a novel member of the\n            <jats:italic>aac(6\u2032)-I<\/jats:italic>\n            family and mutations in drug resistance genes.\n          <\/jats:p>","DOI":"10.1128\/aac.49.9.3734-3742.2005","type":"journal-article","created":{"date-parts":[[2005,8,26]],"date-time":"2005-08-26T22:07:52Z","timestamp":1125094072000},"page":"3734-3742","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":67,"title":["Multidrug-Resistant\n            <i>Pseudomonas aeruginosa<\/i>\n            Strain That Caused an Outbreak in a Neurosurgery Ward and Its\n            <i>aac(6\u2032)-Iae<\/i>\n            Gene Cassette Encoding a Novel Aminoglycoside Acetyltransferase"],"prefix":"10.1128","volume":"49","author":[{"given":"Jun-ichiro","family":"Sekiguchi","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsukasa","family":"Asagi","sequence":"additional","affiliation":[{"name":"National Hospital Organization, Sendai Medical Center, Miyagino 2-8-8, Miyagino, Sendai 938-8520"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tohru","family":"Miyoshi-Akiyama","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Fujino","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Intetsu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Mitsubishi Kagaku Bio-Clinical Laboratories, Inc., 3-30-1 Shimura, Itabashi, Tokyo 174-855"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Kyorin University School of Health Sciences, 476 Miyashita, Hachioji, Tokyo 192-8508"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"National Hospital Organization, Sendai Medical Center, Miyagino 2-8-8, Miyagino, Sendai 938-8520"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadatoshi","family":"Kuratsuji","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Research 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