Conjugative plasmids interact with insertion sequences to shape the horizontal transfer of antimicrobial resistance genes

Significance There is great interest in understanding how antibiotic resistance is disseminated by MGEs (i.e., plasmids, insertion sequences, and integrons). We have systematically investigated their interactions in mediating the horizontal transfer of resistance by combining in silico genomic analysis of a large collection of complete bacterial plasmids (14,029) and genomes (12,059), and then confirmed the interactions we observe in nature using direct experimental approaches. We showed a whole picture of all the IS-associated transfer patterns of AMR genes across different genetic backgrounds and our results highlight the significant relationships between conjugative plasmids and ISs in shaping the dissemination of AMR genes.