Fig. 5
blaCTX-M gene on a large chromosomal insertion in E. cloacae. Zam_UTH_44. This E. cloacae ST316 strain carried blaCTX-M-15 on a ~ 41 kb chromosomal insertion that exhibited nucleotide sequence homology with plasmid pCRENT-193_1 (GenBank accession no. CP024813.1). ISEcp1 was located 255 bp upstream of blaCTX-M-15. The insertion also included diverse AMR genes encoding resistance to six antimicrobial classes, namely; aminoglycosides (aac(3)-IIa), quinolones (qnrB1), aminoglycosides/quinolones (aac(6′)-Ib-cr5), β-lactams (blaOXA-1), trimethoprim (dfrA14), chloramphenicol (catB3), and tetracyclines (tet(A)). The phenotypic AMR profile of this strain was consistent with the AMR genotype of the insertion. F8, F9, R8, R9; primers used for confirmation of insertions. White; susceptible. Black; resistance phenotype in the absence of corresponding AMR gene. Red; β-lactam resistance. Brown; chloramphenicol resistance. Green; aminoglycoside and/or quinolone resistance. Pink; tetracycline resistance