Novel transferable resistance-nodulation-division pump gene cluster tmexCD2-toprJ2 that confers tigecycline resistance in Raoultella ornithinolytica.

We recently identified a novel plasmid-mediated RND-type efflux pump gene cluster, tmexCD1-toprJ1 in Klebsiella pneumoniae, that conferred resistance to multiple antimicrobials, including tigecycline. While homologs of tmexCD1-toprJ1 were found encoded in many other bacterial species in GenBank, their function and transfer mechanism remain unknown. This study identified another mobile gene cluster, tmexCD2-toprJ2, co-occurring on both plasmid (pHNNC189-2) and chromosome of a clinical Raoultella ornithinolytica strain NC189 producing KPC-2, NDM-1, and RmtC. tmexCD2-toprJ2 shares high similarity at nucleotide level to tmexCD1-toprJ1 with 98.02%, 96.75%, and 99.93% identity, respectively. Phylogenetic analysis revealed that tmexCD2-toprJ2 may have originated from chromosome of a Pseudomonas species. Expression of tmexCD2-toprJ2 in Escherichia coli strain resulted in an 8-fold increase of tigecycline MIC and decreased susceptibility to other antimicrobials. Genetic context analyses demonstrated that tmexCD2-toprJ2, together with the adjacent hypothetical site-specific integrase genes, was possibly captured and mobilized by a XerD-like tyrosine recombinase system, forming a putative transposition unit (xerD-like-int-thf2-ybjD-umuD-ΔumuC1-int1-int2-hp1-hp2-tnfxB2-ISBvi2-tmexCD2-toprJ2-ΔumuC1), which was inserted into umuC-like genes in both the NC189 plasmid pHNNC189-2 and chromosome. As tmexCD1-toprJ1 and tmexCD2-toprJ2 could confer multidrug resistance, the spread of these gene clusters, associated with the new recombinase system, calls for more attention.