A study of mutations in Escherichia coli that lead to resistance to a commonly used class of antibiotics, fluoroquinolones, finds that 3 separate mutations responsible for resistance were not acquired via step-wise evolution but instead acquired at once, via 11 simultaneous gene recombination events between a highly resistant and a highly pathogenic E. coli strain; the result was a global spread of a pandemic multidrug-resistant strain that possibly emerged within the last 12 years, according to the authors.
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Article #19-03002: "Pandemic fluoroquinolone resistant Escherichia coli clone ST1193 emerged via simultaneous homologous recombinations in 11 gene loci," by Veronika Tchesnokova et al.
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Proceedings of the National Academy of Sciences