b Plasmid-mediated kanamycin resistance was detected in a strain of Mycobacterium abscessus subsp. bolletii responsible for a nationwide epidemic of surgical infections in Brazil. The plasmid did not influence susceptibility to tobramycin, streptomycin, trimethoprim-sulfamethoxazole, clarithromycin, or ciprofloxacin. Plasmid-mediated drug resistance has not been described so far in mycobacteria. P lasmid-mediated drug resistance is uncommon in mycobacteria. A 56,267-bp circular plasmid of the broad-host-range IncP-1 subgroup was detected in a strain of Mycobacterium abscessus subsp. bolletii (formerly known as Mycobacterium massiliense [1] and Mycobacterium abscessus subsp. massiliense [2]) that was responsible for a nationwide outbreak of mycobacterial surgical infections in Brazil in 2004Brazil in to 2008. This plasmid, named pMAB01, contains a complete system for conjugative DNA transfer and two genetic load regions carrying antimicrobial resistance genes, including the Tn5393c streptomycin resistance (str) transposon and a typical class 1 integron with an incorporated gene cassette encoding an aminoglycoside 6=-N-acetyltransferase (aac[6=]-Ib), the dihydropteroate synthase type 1 gene (sul1), and a conserved open reading frame (orf5) that carries a GCN5-like N-acetyltransferase (3). We investigated the contribution of this plasmid to antimicrobial drug resistance in M. abscessus and in Escherichia coli.The MICs of streptomycin (STR), kanamycin (KAN), tobramycin (TOB), trimethoprim-sulfamethoxazole (SXT), clarithromycin (CLR), and ciprofloxacin (CIP) were evaluated against the prototype M. abscessus subsp. bolletii outbreak strain INCQS 00594, the INCQS 00594 strain cured of the plasmid after 10 in vitro passages in liquid medium, and two additional outbreak isolates, one harboring the pMAB01 plasmid and one lacking it (Fig. 1A). Two E. coli strains, BL21(DE3) and a spontaneous mutant of E. coli C600 (5) showing nalidixic acid resistance (C600Nal r ), and the same strains harboring the pMAB01 plasmid were tested (Fig. 1B). The experiments performed to introduce pMAB01 into E. coli were detailed in a previous publication (3). In brief, competent E. coli BL21(DE3) isolates were transformed by electroporation with the pMAB01 plasmid purified from the INCQS 00594 isolate. In addition, mating experiments were carried out to confirm the conjugative capacity of the pMAB01 plasmid. Conjugative transfer of pMAB01 from M. abscessus to E. coli BL21(DE3) occurred at a frequency of 5.24 ϫ 10 Ϫ8 transconjugants/recipient and from the E. coli BL21(DE3) transconjugant to another E. coli strain, C600Nal r , at a frequency of 1.14 ϫ 10 Ϫ6 transconjugants/recipient (3). The E. coli C600Nal r strain was used as recipient in mating experiments with two E. coli strains to simplify the screening of E. coli transconjugants on nalidixic acid plates.The MICs were determined by the broth microdilution method according to Clinical and Laboratory Standards Institute documents M24-A2 and M100-S23 (6, 7). M. abscessus subsp. bolletii ...