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The IS CR1  (Insertion sequence Common Region) element is the most widespread member of the IS CR  family, and is frequently present within γ-proteobacteria that occur in clinical settings. IS CR1  is always associated with the 3′Conserved Segment (3′CS) of class 1 integrons. IS CR1  contains outward-oriented promoters P OUT , that may contribute to the expression of downstream genes. In IS CR1 , there are two P OUT  promoters named P CR1-1  and P CR1-2 . We performed an  in silico  analysis of all publically available IS CR1  sequences and identified numerous downstream genes that mainly encode antibiotic resistance genes and that are oriented in the same direction as the P OUT  promoters. Here, we showed that both P CR1-1  and P CR1-2  significantly increase the expression of the downstream genes  bla  CTX-M-9  and  dfrA19 . Our data highlight the role of IS CR1  in the expression of antibiotic resistance genes, which may explain why IS CR1  is so frequent in clinical settings.

The Role of ISCR1-Borne POUT Promoters in the Expression of Antibiotic Resistance Genes