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. 2020 Aug 25;21(17):6133. doi: 10.3390/ijms21176133

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© 2020 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Genomic prevalence of the aac(3)-IV gene in Gram-negative clinical isolates in comparison to RMTase resistance genes. (a) Gene-annotation analysis of 182,405 clinical-isolate genomes deposited in NCBI National Database of Antibiotic Resistant Organisms (NDARO) on 24 June 2020. (b) Gene-annotation analysis in a subpopulation of 21,195 carbapenemase-positive (CP) clinical isolates. Gene aac(3)-IV confers resistance to gentamicin, tobramycin, and apramycin, among others. RMTases confer pan-aminoglycoside resistance to all 4,6-disubstituted deoxystreptamines comprising all standard-of-care aminoglycoside antibiotics, but remain susceptible to apramycin.