Clonal Dissemination of Pseudomonas aeruginosa Sequence Type 235 Isolates Carrying bla IMP-6 and Emergence of bla GES-24 and bla IMP-10 on Novel Genomic Islands PAGI-15 and -16 in South Korea

A total of 431Pseudomonas aeruginosa clinical isolates were collected from 29 general hospitals in South Korea in 2015. Antimicrobial susceptibility was tested by the disk diffusion method, and MICs of carbapenems were determined by the agar dilution method. Carbapenemase genes were amplified by PCR and sequenced, and the structures of class 1 integrons surrounding the carbapenemase gene cassettes were analyzed by PCR mapping. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were performed for strain typing. Whole-genome sequencing was carried out to analyzeP. aeruginosa genomic islands (PAGIs) carrying thebla IMP-6 ,bla IMP-10 , andbla GES-24 genes. The rates of carbapenem-nonsusceptible and carbapenemase-producingP. aeruginosa isolates were 34.3% (148/431) and 9.5% (41/431), respectively. IMP-6 was the most prevalent carbapenemase type, followed by VIM-2, IMP-10, and GES-24. All carbapenemase genes were located on class 1 integrons of 6 different types on the chromosome. All isolates harboring carbapenemase genes exhibited genetic relatedness by PFGE (similarity > 80%); moreover, all isolates were identified as sequence type 235 (ST235), with the exception of two ST244 isolates by MLST. Thebla IMP-6 ,bla IMP-10 , andbla GES-24 genes were found to be located on two novel PAGIs, designated PAGI-15 and PAGI-16. Our data support the clonal spread of an IMP-6-producingP. aeruginosa ST235 strain, and the emergence of IMP-10 and GES-24 demonstrates the diversification of carbapenemases inP. aeruginosa in Korea.