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The microbiota in the human gastrointestinal tract (GIT) is highly exposed to antibiotics, and may be an important reservoir of resistant strains and transferable resistance genes. Maternal GIT strains can be transmitted to the offspring, and resistances could be acquired from birth. This is a case study using a metagenomic approach to determine the diversity of microorganisms conferring tetracycline resistance (Tc r ) in the guts of a healthy mother-infant pair one month after childbirth, and to investigate the potential for horizontal transfer and maternal transmission of Tc r  genes. Fecal fosmid libraries were functionally screened for Tc r , and further PCR-screened for specific Tc r  genes. Tc r  fosmid inserts were sequenced at both ends to establish bacterial diversity. Mother and infant libraries contained Tc r , although encoded by different genes and organisms. Tc r  organisms in the mother consisted mainly of Firmicutes and Bacteroidetes, and the main gene detected was  tet (O), although  tet (W) and  tet (X) were also found. Identical Tc r  gene sequences were present in different bacterial families and even phyla, which may indicate horizontal transfer within the maternal GIT. In the infant library, Tc r  was present exclusively in streptococci carrying  tet (M),  tet (L) and  erm (T) within a novel composite transposon, Tn 6079 . This transposon belongs to a family of broad host range conjugative elements, implying a potential for the joint spread of tetracycline and erythromycin resistance within the infant's gut. In addition, although not found in the infant metagenomic library,  tet (O) and  tet (W) could be detected in the uncloned DNA purified from the infant fecal sample. This is the first study to reveal the diversity of Tc r  bacteria in the human gut, to detect a likely transmission of antibiotic resistance from mother to infant GITs and to indicate the possible occurrence of gene transfers among distantly related bacteria coinhabiting the GIT of the same individual.

The Gut as Reservoir of Antibiotic Resistance: Microbial Diversity of Tetracycline Resistance in Mother and Infant