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dc.contributor.authorJavkar, Kiran
dc.contributor.authorRand, Hugh
dc.contributor.authorHoffmann, Maria
dc.contributor.authorLuo, Yan
dc.contributor.authorSarria, Saul
dc.contributor.authorThirunavukkarasu, Nagarajan
dc.contributor.authorPillai, Christine A.
dc.contributor.authorMcGann, Patrick
dc.contributor.authorJohnson, J. Kristie
dc.contributor.authorStrain, Errol
dc.contributor.authorPop, Mihai
dc.description.abstractCarbapenems—one of the important last-line antibiotics for the treatment of gram-negative infections—are becoming ineffective for treating Acinetobacter baumannii infections. Studies have identified multiple genes (and mechanisms) responsible for carbapenem resistance. In some A. baumannii strains, the presence/absence of putative resistance genes is not consistent with their resistance phenotype—indicating the genomic factors underlying carbapenem resistance in A. baumannii are not fully understood. Here, we describe a large-scale whole-genome genotype-phenotype association study with 349 A. baumannii isolates that extends beyond the presence/absence of individual antimicrobial resistance genes and includes the genomic positions and pairwise interactions of genes. Ten known resistance genes exhibited statistically significant associations with resistance to imipenem, a type of carbapenem: blaOXA-23, qacEdelta1, sul1, mphE, msrE, ant(3”)-II, aacC1, yafP, aphA6, and xerD. A review of the strains without any of these 10 genes uncovered a clade of isolates with diverse imipenem resistance phenotypes. Finer resolution evaluation of this clade revealed the presence of a 38.6 kbp conserved chromosomal region found exclusively in imipenem-susceptible isolates. This region appears to host several HTH-type DNA binding transcriptional regulators and transporter genes. Imipenem-susceptible isolates from this clade also carried two mutually exclusive plasmids that contain genes previously known to be specific to imipenem-susceptible isolates. Our analysis demonstrates the utility of using whole genomes for genotype-phenotype correlations in the context of antibiotic resistance and provides several new hypotheses for future research.en_US
dc.description.sponsorshipU.S. Food and Drug Administrationen_US
dc.publisherFrontiers Media SAen_US
dc.relation.ispartofFrontiers in Microbiologyen_US
dc.subject.meshAcinetobacter baumannii--geneticsen_US
dc.subject.meshDrug Resistance, Bacterial--geneticsen_US
dc.titleWhole-Genome Assessment of Clinical Acinetobacter baumannii Isolates Uncovers Potentially Novel Factors Influencing Carbapenem Resistanceen_US

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