耐多药鲍曼不动杆菌耐药基因检测结果的样本聚类分析

目的 调查一组耐药鲍曼不动杆菌菌株间的亲缘关系.方法 收集2010年1月至2010年12月浙江某医院ICU患者痰液标本中分离的耐药鲍曼不动杆菌共20株,采用聚合酶链反应(PCR)的方法分析3种与耐药相关的看家基因(carO、gyrA、parC)和55种水平转移获得与β-内酰胺类、氨基糖苷类、喹诺酮类耐药相关基因以及12种接合性质粒、转座子、插入序列、整合子等可移动遗传元件遗传标记,再对检测结果作样本聚类分析.结果 20株耐药鲍曼不动杆菌共检出3种与耐药相关的看家基因carO、gyrA、parC,4种获得性β-内酰胺类耐药基因(TEM-1、ADC-30、ADC-60、OXA-23),5种获得性氨基糖苷类耐药基因[aac(3)-Ⅰ、aac(6')-Ⅰ b、ant(3”)-Ⅰ、aph(3’)-Ⅰ、armA],2种抗菌制剂外排泵基因(adeB、qacE△1),5种可移动遗传元件的遗传标记(int Ⅰ 1、tnpU、tnp513、IS26、ISaba1).样本聚类分析提示,20株耐药鲍曼不动杆菌可分为A与B二个簇,A簇群均为多耐药(MDR)株;A簇群又可分为A1(ADC-60阳性)与A2簇群(ADC-30阳性),均为克隆传播.B簇群均为泛耐药(PDR)株,除8号株外为克隆传播.结论 MDR和PDR菌株中均存在克隆传播.获得菌株之间的亲缘关系对院内感染实时监测和控制院内感染意义重大.     

鲍曼不动杆菌的耐药性检测及泛耐药菌株的耐药基因研究

目的考察临床分离的鲍曼不动杆菌的耐药性并对泛耐药菌株的耐药基因进行检测。方法用纸片扩散法对60株临床分离鲍曼不动杆菌进行药物敏感试验,并用PCR法检测8株泛耐药菌株携带7种耐药基因OXA-51、OXA-23、OXA-24、OXA-58、aac(3)-Ⅰ、gyr A、abe M的情况。结果所分离的鲍曼不动杆菌对临床常用的β-内酰胺类抗生素、氨基糖苷类抗生素、四环素类抗生素、磺胺类抗菌药及喹诺酮类抗菌药均产生耐药性;在8株泛耐药鲍曼不动杆菌中OXA-51、OXA-23、OXA-58、gyr A、abe M基因检测均全部呈阳性;OXA-24基因检测均呈阴性;aac(3)-I基因检测有5株呈阳性,3株呈阴性。结论鲍曼不动杆菌耐药情况严重,其耐药机制与多种耐药基因密切相关。     

内蒙古地区临床危重患者三种常见感染细菌耐药基因的检测及耐药性分析

目的:探讨内蒙古地区临床危重患者常见感染细菌耐药基因的检测及耐药性相关因素,以便临床合理运用抗菌药物,为病原菌感染的预防和控制提供依据。方法:选取2010年1月至2013年1月在我院重症监护室治疗的病例中检测出的215株细菌为研究对象,运用相关的检测手段分析细菌的耐药性和耐药基因情况。结果:经过临床的检测后得出大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌分别为85株、55株和75株,其中产ESBLs大肠埃希菌54株,非产ESBLs大肠埃希菌31株;产ESBLs肺炎克雷伯菌15株,非产ESBLs肺炎克雷伯菌40株。大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌对美罗培南、亚胺培南的敏感性最高,且在产与非产ESBLs菌株耐药上比较有差异性(P0.05);产与非产ESBLs菌株耐药基因检测方面比较无明显差异性(P0.05)。结论:大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌均存在多重耐药情况,且耐药与喹诺酮耐药机制有一定的相关性。     

多耐药肺炎克雷伯菌获得性耐药基因检测及指标聚类分析

目的调查多耐药肺炎克雷伯菌中65种获得性耐药基因和7种可移动遗传元件遗传标记基因的存在状况,以及获得性耐药基因和可移动遗传元件遗传标记基因的相关性。方法收集绍兴地区六家医院分离的肺炎克雷伯菌共20株,采用PCR的方法分析65种β-内酰胺类、氨基糖苷类、喹诺酮类获得性耐药基因和7种转座子、插入序列、接合性质粒遗传标记基因,并用指标聚类分析(SPSS法)分析β-内酰胺类、氨基糖苷类和喹诺酮类获得性耐药基因与整合子、转座子、插入序列、接合性质粒遗传标记基因的相关性。结果 20株肺炎克雷伯菌共检测到14种获得性耐药基因(包括6种β-酰胺类获得性耐药基因、6种氨基糖苷类获得性耐药基因、2种喹诺酮类获得性耐药基因)和6种可移动遗传元件遗传标记基因(包括1种整合子遗传标记基因、3种转座子和插入序列基因遗传标记基因、2种接合性质粒遗传标记基因),其余52种基因均未检测到。SPSS法将上述阳性检出基因分成两大簇群。结论绍兴地区六家医院的多耐药肺炎克雷伯菌菌株对抗菌药物的耐药表型与获得性耐药基因相关,且可移动遗传元件的水平转移使细菌的耐药性在同种细菌菌株之间甚至不同种细菌菌株之间得以快速传播。获得性耐药基因与可移动遗传元件遗传标记基因的指标聚类分析显示:OXA-1、aac(6’)-Ⅰb、qnrB、IMP、aadA5、VEB、KPC、qnrS等基因与接合性质粒遗传标记traA相关,提示这些基因在F接合性质粒上;DHA、aph(3′)-Ⅰ等基因与转座子遗传标记tnpU、tnp513相关,提示它们位于转座子上;TEM-1、aac(3)-Ⅱ、qacE△1与接合性质粒遗传标记trbC相关,提示TEM-1、aac(3)-Ⅱ等基因和Ⅰ类整合子可能位于宽范围接合性质粒上;ant(3″)-Ⅰ、rmtB等基因与ISEcp1较为相关,提示这些基因位于插入序列上。     

从耐药鲍曼不动杆菌中发现β-内酰胺酶ADC基因和膜孔蛋白carO基因新的变异型

目的 调查一组耐药鲍曼不动杆菌中β-内酰胺酶基因和膜孔蛋白基因的存在和变异情况.方法 收集2010年1月至2010年12月浙江某医院ICU患者痰液标本中分离的多耐药和泛耐药鲍曼不动杆菌各10株,用分子鉴定法鉴定菌种,再用聚合酶链反应(PCR)及序列分析的方法分析34种β-内酰胺酶基因与膜孔蛋白carO基因.结果 本组20株耐药鲍曼不动杆菌共检出TEM-1型20株(100％)、OXA-23型10株(50.0％)、ADC-30型12株(60.0％)、ADC基因新的变异型ADC-60型8株(40.0％)(GenBank登录号:JQ692087).10株PDR菌均检出OXA-23型β-内酰胺酶基因,而10株MDR菌则均未检出OXA-23型β-内酰胺酶基因.20株耐药鲍曼不动杆菌膜孔蛋白carO基因均存在有义突变,19株测得序列相同,翻译成氨基酸序列后与鲍曼不动杆菌敏感株(SDF)比较,一致率为76.0％.8号株carO基因序列与其他19株测得DNA序列不同,第351位缺失了12个碱基并导致过早出现终止密码子.结论 本组鲍曼不动杆菌对β-内酰胺类药物耐药主要与产TEM、ADC、OXA-23和carO基因存在有义突变相关.OXA-23型β-内酰胺酶基因阳性是PDR菌耐碳青霉烯类药物的原因.ADC基因存在新变异型:ADC-60是国内外首次报道.     

多重耐药鲍曼不动杆菌耐药性及β-内酰胺酶耐药基因的研究

研究多重耐药鲍曼不动杆菌的耐药性及β-内酰胺酶耐药基因的携带情况。采用VIKET Compact 2 全自动细菌鉴定系统进行细菌鉴定,采用纸片扩散法（K-B法）测定鲍曼不动杆菌对抗菌药物的耐药性,应用聚合酶链反应（PCR）法检测β-内酰胺酶耐药基因。32株多重耐药鲍曼不动杆菌对13种常用抗菌药物的耐药率均>80%,对亚胺培南和美罗培南耐药率分别高达78.1%和71.9%,头孢哌酮/舒巴坦耐药率31.3%,多粘菌素B抗菌活性最好,耐药率0%。检出超广谱β-内酰胺酶（ESBLs）和头孢菌素酶（AmpC）耐药基因,未检出金属β-内酰胺酶（MBLs）耐药基因。32株多重耐药鲍曼不动杆菌TEM基因均阳性,17株检出PER基因,29株检出ADC基因。有16株菌同时携带TEM、PER、ADC基因。结果表明,同时携带TEM、PER、ADC基因是安徽医科大学解放军174临床学院鲍曼不动杆菌产生多重耐药性的原因之一。     

100例鲍曼不动杆菌的耐药性与整合子表达及耐药基因分析

目的 了解鲍曼不动杆菌的耐药性和整合子表达及耐药基因携带情况.方法 收集100株鲍曼不动杆菌,以VITEK-64系统鉴定细菌,并进行14种抗生素药敏试验,通过PCR法检测Ⅰ、Ⅱ、Ⅲ类整合酶基因(intI1、2、3)及Ⅰ类整合子可变区基因盒,并对基因盒测序.结果 除阿米卡星和头孢哌酮/舒巴坦,鲍曼不动杆菌对其他12种抗菌药物耐药率均大于60.0％,多重耐药率为88.0％.鲍曼不动杆菌整合酶基因阳性率为64.0％,均为intI1,整合子阳性菌株对多数药物的耐药率显著高于整合子阴性者(P＜0.05).intI1阳性菌株中,84.4％ (54/64)扩增出整合子可变区,检出3种耐药基因盒组合形式:aac(6’)-Ib-cr-arr-3-dfrA27 14株、aacA4-catB8-aadA1 24株、aacC1-orfA-orfB-aadA1 16株.结论 临床分离的鲍曼不动杆菌多重耐药与Ⅰ类整合子表达有关.Ⅰ类整合子主要携带早期使用的氨基糖苷类抗菌药、甲氧苄啶和氯霉素耐药基因.     

鲍曼不动杆菌对β-内酰胺类药物的耐药性及相关耐药基因的研究

采用琼脂二倍稀释法及聚合酶链式反应(PCR)对36株鲍曼不动杆菌的耐药性及相关耐药基因(blaTEM、blaSHV、blaIMP、blaVIM、blaOXA-23)进行检测。结果表明,36株鲍曼不动杆菌对哌拉西林和替卡西林的耐药率最高,为94.4%;对亚胺培南的耐药率最低,为52.8%;在β-内酰胺酶耐药基因检测过程中,发现有3株菌株携带有blaTEM、blaVIM、blaOXA-233种基因,且对12种实验药物均耐药,表明菌株的耐药性与其携带的耐药基因数目有关,数目越多,耐药性越强。     

福建某基层医院CRE碳青霉烯类耐药基因分析

目的对福建省南平市第二医院分离的碳青霉烯类耐药肠杆菌科细菌进行碳青霉烯类基因和其他β内酰胺类耐药基因检测。方法收集碳青霉烯类耐药肠杆菌科细菌,采用Vitek-2 Compact全自动细菌鉴定/药敏仪器进行细菌鉴定和药敏试验;采用改良Hodge试验对实验菌株进行表型检测;利用PCR及测序法对常见的碳青霉烯类和β-内酰胺类耐药基因进行检测;质粒接合试验检测碳青霉烯类耐药基因是否具有可转移性。结果共收集到4株碳青霉烯类耐药肠杆菌科细菌,呈多重耐药性。2株改良Hodge试验阳性。试验菌株均检出碳青霉烯类耐药基因(NDM-1、IMP-8或VIM-2),并同时携带有其他β内酰胺类基因;4株细菌中有3株的碳青霉烯类耐药基因接合成功。结论碳青霉烯类耐药肠杆菌科细菌已在福建基层医院出现,并具有一定传播性,应引起相关主管部门的注意,以防耐药菌的流行。     

鲍曼不动杆菌错配修复基因mutL的序列及其系统进化关系分析

目的探讨中南大学湘雅二医院于2008-2009年临床分离到的不同基因型和耐药型的鲍曼不动杆菌的错配修复基因mutL的系统进化关系。方法以PCR扩增这一时期内5株分离自不同科室,具有不同基因型和耐药表型的鲍曼不动杆菌的错配修复基因mutL,运用软件ClustalX 1.83对mutL序列进行分析,基于该分析运用软件Mega 5.0采用邻接法(N-J法)构建系统进化树分析其系统进化关系。结果 (1)耐药型相同(对临床常用15种抗生素均耐药)的3株菌mutL序列完全一致,遗传距离为0.000;耐药型相似(对临床常用15种抗生素大多数敏感)的2株菌mutL序列相似度为98.95%,遗传距离为0.011,而与前3株的相对遗传距离大约分别为0.013和0.015;(2)序列分析显示这5株菌的mutL序列共发生了16个基因突变,其中有7个简约信息位点和9个自裔位点,这些突变导致了翻译过程中的12个错义突变、3个无义突变和2个同义突变。结论 (1)湘雅二医院2008-2009年发生过多重耐药鲍曼不动杆菌的院内交叉感染;(2)mutL序列中若干位点的基因突变会导致鲍曼不动杆菌耐药性变化,即错配修复基因mutL与鲍曼不动杆菌的耐药性状有关。     

Distribution of blaOXA genes among carbapenem-resistant Acinetobacter baumannii nosocomial strains in Poland

Acinetobacter baumannii is an important nosocomial pathogen occurring particularly in intensive care (ICU) as well as burn therapy units (BTU). A. baumannii strains have emerged as resistant to almost all antimicrobial agents, including carbapenems. b-lactamase-mediated resistance is the most common mechanism for carbapenem resistance in this species. Carbapenem-hydrolysing class D b-lactamases - OXA are widespread among A. baumannii strains. It is suggested that ISAba1 plays an important role in drug resistance. The aims of the study were detection of OXA encoding genes and presence of ISAba1. The study included the total of 104 isolates of carbapenem-resistant A. baumannii, obtained from patients hospitalized in ICU and BTU of Specialized Hospital in Krakow. Multiplex PCR was applied for detection of selected OXA carbapenemases encoding genes. PCR analysis showed the presence of bla OXA-51-like gene and ISAba1 in all isolates. 46 strains carried bla OXA-51-like and bla OXA-23-like genes while 48 bla OXA-51-like and bla OXA-40-like genes. 3 isolates carried: bla OXA-51-like , bla OXA-23-like and bla OXA-40-like genes. 7 strains encoded an OXA-51-like carbapenemase but were negative for enzymes belonging to the other families tested. Comparative analysis of ICU and BTU isolates revealed the dominance of: bla OXA-51-like and bla OXA-40-like among ICU while bla OXA-51-like and bla OXA-23-like in BTU.     

Diversity of aminoglycoside modifying enzyme genes among multidrug resistant Acinetobacter baumannii genotypes isolated from nosocomial infections in Tehran hospitals and their association with class 1 integrons

The aim of the present study was to investigate, for the first time, the diversity of the genes encoding aminoglycoside-modifying enzymes (AME) and their association with class 1 integrons in Iranian Acinetobacter baumannii strains. A total of 100 multidrug resistant A. baumannii, isolated from eight distinct hospitals in Tehran, were enrolled in this study. Susceptibility of these isolates to antimicrobial agents including gentamicin and amikacin was determined by E-test. Aminoglycoside resistant isolates were then tested by PCR for AME genes, including aphA6, aacC1, aacC2, aacA4, aadB, aadA1, classes 1 integron, 5'-CS-3' and typed by RAPD PCR. The rate of resistance to imipenem, meropenem, gentamicin and amikacin were 39%, 39%, 38% and 32%, respectively. Intermediate resistance phenotype to gentamicin and amikacin was observed in 2% and 5% of all the isolates, respectively. After aph6 with 90% (n = 36/40), aadA1, aacC1 and aadB with 82.5% (n = 33/40), 65% (n = 26/40) and 20% (n = 8/40) were the most prevalent AME genes among aminoglycosides resistant A. baumannii isolates. A combination of two to four different resistance genes was observed in 39 of 40 strains (97.5%), with a total of 7 different combinations. PCR of integrase genes revealed that AME gene was associated with 67% of class 1 integrons. RAPD analysis showed three predominant genotypes A (n = 20), B (n = 10) and 10 unrelated genotypes. The occurrence of identical resistance genes, gene combinations and class 1 integrons associated with these genes in clonally distinct strains indicates that horizontal gene transfer plays a major role in the dissemination of aminoglycoside resistance in A. baumannii.     

Parallel gene loss and acquisition among strains of different Brucella species and biovars

The genus Brucella is divided into six species; of these, B. melitensis and B. abortus are pathogenic to humans, and B. ovis and B. neotomae are nonpathogenic to humans. The definition of gene loss and acquisition is essential for understanding Brucella's ecology, evolutionary history, and host relationships. A DNA microarray containing unique genes of B. melitensis Type strain 16MT and B. abortus 9-941 was constructed and used to determine the gene contents of the representative strains of Brucella. Phylogenetic relationships were inferred from sequences of housekeeping genes. Gene loss and acquisition of different Brucella species were inferred. A total of 214 genes were found to be differentially distributed, and 173 of them were clustered into 15 genomic islands (GIs). Evidence of horizontal gene transfer was observed for 10 GIs. Phylogenetic analysis indicated that the 19 strains formed five clades, and some of the GIs had been lost or acquired independently among the different lineages. The derivation of Brucella lineages is concomitant with the parallel loss or acquisition of GIs, indicating a complex interaction between various Brucella species and hosts.     

重症监护病房呼吸机相关性肺炎中鲍曼不动杆菌耐药性的动态分析

目的探讨重症监护病房呼吸机相关性肺炎(VAP)中鲍曼不动杆菌(Acinetobacter baumannii,Ab)的分布特点和耐药性,为临床防治鲍曼不动杆菌感染提供依据。方法对机械通气>48 h的79例患者的气管抽吸物(ETA)进行细菌定量培养和药敏测定。结果回顾性分析79例VAP患者ETA培养出病原菌214株,其中鲍曼不动杆菌79株(36.9%)。鲍曼不动杆菌对常见抗菌药物的耐药率呈上升趋势,出现较多多重耐药和泛耐药菌株。头孢哌酮/舒巴坦和亚胺培南的耐药率分别是55.6%和68.4%,均呈上升趋势。结论鲍曼不动杆菌是VAP常见病原菌之一,鲍曼不动杆菌的耐药性呈上升趋势,特别是多重耐药和泛耐药菌株,应引起高度重视。     

Detection of recombination among Salmonella enterica strains using the incongruence length difference test

Particular serovars of Salmonella enterica have emerged as significant foodborne pathogens in humans. At the chromosomal level, discrete regions in the Salmonella genome have been identified that are known to play important roles in the maintenance, survival, and virulence of S. enterica within the host. Interestingly, several of these loci appear to have been acquired by horizontal transfer of DNA among and between bacterial species. The profound importance of recombination in pathogen emergence is just now being realized, perhaps explaining the sudden interest in developing novel and facile ways for detecting putative horizontal transfer events in bacteria. The incongruence length difference (ILD) test offers one such means. ILD uses phylogeny to trace sequences that may have been acquired promiscuously by exchange of DNA during chromosome evolution. We show here that the ILD test readily detects recombinations that have taken place in several housekeeping genes in Salmonella as well as genes composing the type 1 pilin complex (14 min) and the inv-spa invasion gene complex (63 min). Moreover, the ILD test indicated that the mutS gene (64 min), whose product helps protect the bacterial genome from invasion by foreign DNA, appears to have undergone intragenic recombination within S. enterica subspecies I. ILD findings were supported using additional tests known to be independent of the ILD approach (e.g., split decomposition analysis and compatibility of sites). Taken together, these data affirm the application of the ILD test as one approach for identifying recombined sequences in the Salmonella chromosome. Furthermore, horizontally acquired sequences within mutS support a model whereby evolutionarily important recombinants of S. enterica are rescued from strains carrying defective mutS alleles via horizontal transfer.     

Diverse genomic species and evidences of symbiotic gene lateral transfer detected among the rhizobia associated with Astragalus species grown in the temperate regions of China

Based on the analyses of ribosomal DNA and housekeeping genes, a total of 118 bacterial isolates obtained from 13 Astragalus species grown in the temperate region of China were identified as 19 genomic species of Mesorhizobium, Rhizobium, Sinorhizobium and Bradyrhizobium, two of them being putatively new species. Phylogenetic comparison of symbiotic genes (nodC and nifH) and housekeeping genes showed that the symbiotic genes of the Astragalus rhizobia were maintained by both vertical and horizontal transfer. The results demonstrated that the Astragalus species were very promiscuous hosts for rhizobia and that their rhizobia had very diverse genomic and symbiotic gene backgrounds.     

多重耐药肺炎克雷伯菌获得性耐药相关基因和可移动遗传元件检测与指标聚类分析

目的 探讨一组多重耐药肺炎克雷伯菌(MDR-KPN)中获得性耐药相关基因和可移动遗传元件遗传标记的存在状况以及二者的相关性.方法 收集2008年8月至2010年5月浙江省杭州市和湖州市6所医院共47株MDR-KPN,采用聚合酶链反应(PCR)的方法分析74种获得性耐药基因和24种可移动遗传元件遗传标记,并用指标聚类分析(SPSS法)分析获得性耐药相关基因和可移动遗传元件遗传标记的相关性.结果 47株MDR-KPN共检出5种β-内酰胺类获得性耐药基因、6种氨基糖苷类获得性耐药基因、3种喹诺酮类获得性耐药基因、6种其他获得性耐药基因、1种整合子遗传标记、2种转座子遗传标记、4种插入序列遗传标记、2种接合性质粒遗传标记和1种噬菌体原标记;指标聚类分析(SPSS法)将上述阳性检出基因分成A、B两大簇.结论 指标聚类分析提示获得性耐药相关基因和可移动遗传元件密切相关;由Ⅰ类整合子( intI1)、插入序列(IS26、ISEcp1、ISKpn6)、耐药质粒(trbC)介导的TEM-1和KPC是本组菌株的特征.在肺炎克雷伯菌中做指标聚类分析为国内首次报道.     

产β-内酰胺酶鲍曼不动杆菌基因型研究

目的了解临床科室分离的鲍曼不动杆菌耐药状况并分析多重耐药株产β-内酰胺酶基因型,为有效的临床治疗和医院感染控制提供实验室依据。方法采用纸片扩散（K-B）法测定临床分离的312株鲍曼不动杆菌对13种抗菌药物的敏感性,对其中120株多重耐药株用聚合酶链反应（PCR）扩增β-内酰胺酶基因,并对其扩增产物进行基因测序。结果鲍曼不动杆菌对美洛培南、亚胺培南、头孢哌酮/舒巴坦和替卡西林/克拉维酸的耐药率分别为0.0%、1.0%、30.8%和31.4%,其余抗菌药物耐药率在38.5%-80.1%;120株多重耐药菌株中,β-内酰胺酶基因分布AmpC型基因阳性率为66.7%（80/120）、SHV-12型基因阳性率为14.2%（17/120）,PER-1型基因阳性率为16.7%（20/120）,CTX-M-9型基因阳性率为8.2%（10/120）,TEM-1型基因阳性率为9.2%（11/120）;VER-1,CTX-M-1,CTX-M-2,OXA型均阴性。同时携带2种基因型有16株,携带3种基因型有14株。结论临床分离的鲍曼不动杆菌流行株主要是产AmpC酶,且呈多重耐药。     

Lack of evidence for horizontal transfer of the lac operon into Escherichia coli

The idea that Escherichia coli gained the lac operon via horizontal transfer, allowing it to invade a new niche and form a new species, has become a paradigmatic example of bacterial nonpathogenic adaptation and speciation catalyzed by horizontal transfer. Surprisingly, empirical evidence for this event is essentially nonexistent. To see whether horizontal transfer occurred, I compared a phylogeny of 14 Enterobacteriaceae based on two housekeeping genes to a phylogeny of a part of their lac operon. Although several species in this clade appear to have acquired some or all of the operon via horizontal transfer, there is no evidence of horizontal transfer into E. coli. It is not clear whether the horizontal transfer events for which there is evidence were adaptive because those species which have acquired the operon are not thought to live in high lactose environments. I propose that vertical transmission from the common ancestor of the Enterobacteriaceae, with subsequent loss of these genes in many species can explain much of the patchy distribution of lactose use in this clade. Finally, I argue that we need new, well-supported examples of horizontal transfer spurring niche expansion and speciation, particularly in nonpathogenic cases, before we can accept claims that horizontal transfer is a hallmark of bacterial adaptation.