Novel ICE in MDR H influenzae. A novel Integrative and Conjugative Element conferring Multidrug Resistance in Haemophilus influenzae

A multidrug-resistant (MDR) strain of Haemophilus influenzae, Hi-228, with phenotypic resistance towards ampicillin, cefotaxime, chloramphenicol, gentamicin, and azithromycin, was characterized. Hi-228 carries a novel integrative and conjugative element (ICE), Tn7100, contributing to this remarkable and previously unreported MDR profile. Tn7100 contains two novel transposable elements, Tn7470 and Tn7471, with high sequence identities to a plasmid in Enterobacterales and an ICE in streptococcal species, respectively.