Carbapenemases on the move: it's good to be on ICEs

The evolution and spread of antibiotic resistance is often mediated by mobile genetic elements. Integrative and conjugative elements (ICEs) are the most abundant conjugative elements among prokaryotes. However, the contribution of ICEs to horizontal gene transfer of antibiotic resistance has been largely unexplored. Here we report that ICEs belonging to mating-pair formation (MPF) classes G and T are highly prevalent among the opportunistic pathogen , contributing to the spread of carbapenemase-encoding genes (CEGs). Most CEGs of the MPF class were encoded within class I integrons, which co-harbour genes conferring resistance to other antibiotics. The majority of the integrons were located within Tn -like and composite transposons. Conserved attachment site could be predicted for the MPF class ICEs. MPF class ICEs carried the CEGs within composite transposons which were not associated with integrons. The data presented here provides a global snapshot of the different CEG-harbouring ICEs and sheds light on the underappreciated contribution of these elements to the evolution and dissemination of antibiotic resistance on .