Pseudomonas Acts as a Reservoir of Novel Tigecycline Resistance Efflux Pump tmexC6D6-toprJ1b and tmexCD-toprJ Variants.

Several variants of the plasmid-carried tigecycline resistance gene cluster, , have been identified. This study characterized another novel variant, , located on the chromosome of environmental-origin Pseudomonas mendocina. TMexC6D6-TOprJ1 mediates resistance to multiple drugs, including tigecycline. The promoter activity of and negative transcriptional repression by the upstream regulator tnfxB6 are crucial for the expression of . was found in the plasmids or chromosomes of different Pseudomonas species from six countries. Two genetic backgrounds, class 1 integrons and -carrying integrase units, were found adjacent to the gene cluster and might mediate the transfer of this novel efflux pump gene cluster in Pseudomonas. Further phylogenetic analysis revealed Pseudomonas as the major reservoir of variants, warranting closer monitoring in the future. Tigecycline is one of the treatment options for serious infections caused by multidrug-resistant bacteria, and tigecycline resistance has gained extensive attention. The emergence of a transferable tigecycline resistance efflux pump gene cluster, , severely challenged the efficiency of tigecycline. In this study, we identified another novel variant, , which could confer resistance to multiple classes of antibiotics, including tigecycline. Although was found only in Pseudomonas species, might spread to hosts via mobile genetic elements resembling those of other variants, compromising the therapeutic strategies. Meanwhile, novel transferable variants are constantly emerging and mostly exist in Pseudomonas spp., indicating Pseudomonas as the important hidden reservoir and origin of variants. Continuous monitoring and investigations of are urgent to control its spread.