M ost of the variants of Salmonella genomic island 1 (SGI1) are multidrug resistance (MDR) DNA elements that can be transferred by horizontal gene transfer (HGT) (1). SGI1 was initially described in Salmonella enterica serovar Typhimurium DT104 (1). It consists of a 27.4-kb backbone (28 open reading frames [ORFs]) with an MDR region consisting of a 15-kb complex class 1 integron of the family In104 (1). The SGI1 variant SGI1-L was detected for the first time in Proteus mirabilis and Morganella morganii strains from Palestine in 2006 and from France in 2017, respectively (2, 3). The 3= end of the chromosomal trmE gene is the SGI1-specific integration site in the SGI1-carrying strains (3, 4). Providencia stuartii is Gram-negative bacterium of the family Morganellaceae commonly associated with urinary tract infections or indwelling urinary catheters in hospitalized and nursing home patients (5). It has intrinsic resistance to polymyxin, tigecycline, aminopenicillin, and first-generation cephalosporins (5). Here, we report the first identification (to our knowledge) of SGI1 in a multidrugresistant clinical isolate of P. stuartii. The strain, designed PsTAN3, was isolated from a wound pus swab from a male patient in a teaching hospital in Tanta City, Egypt, in 2014. PsTAN3 was resistant to aztreonam (MIC, Ն512 g/ml), ciprofloxacin (MIC, Ն16 g/ml), chloramphenicol (MIC, Ն512 g/ml), colistin (MIC, Ն128 g/ml), gentamicin (MIC, Ն128 g/ml), tetracycline (MIC, Ն128 g/ml), streptomycin (MIC, Ն512 g/ml), cefoxitin (MIC, Ն256 g/ml), cefoperazone (MIC, Ն512 g/ml), trimethoprim (MIC, Ն512 g/ml), cefotaxime (MIC, Ն512 g/ml), meropenem (MIC, Ն16 g/ml), and nalidixic acid (MIC, Ն512 g/ml) but sensitive to doripenem (MIC, Յ1 g/ml). PsTAN3 was negative by the modified carbapenem inactivation method (mCIM), indicating the absence of carbapenemase production. PCR and DNA sequencing were used to map the entire SGI1 (for a list of PCR primers, see Table S1 in the supplemental material) and identified variant SGI1-W (6, 7). The multidrug resistance region was 6.54 kb with the genetic arrangement intI1-aadA2-lnuF-qacE⌬1-sul1-orf5-orf6-IS6100 (PsTAN3 class 1 integron GenBank accession no. LC370342) (Fig. 1). SGI1-W was integrated at the 3= end of the trmE gene (Fig. 1). The strain also carried bla TEM-1 , bla DHA-1 , qnrD, and floR genes conferring resistance to third-generation cephalosporins, ciprofloxacin, florfenicol, and chloramphenicol, respectively, and the class 1 integrons aadA2 and lnuF. The MDR region of SGI1 in PsTAN3 was 100% identical to that of SGI1-PmC105 reported in a P. mirabilis isolate from a poultry farm in China (7). Furthermore, the circular form was detected in PsTAN3 after two steps of DNA amplification using primers SGI1circ1 and SGI1circ2 with the expected target size (364 bp) (GenBank accession no. LC370343) (see Fig. S1A in the supplemental material). The sequence of the SGI1-W attP site in PsTAN3 (5=-TTCTGTATCGGGAAGTAA-3=) differs in 1 bp (C¡T) from that of S. enterica DT104 and P. mirabilis (5=-TTCTGTATTGGGAAG...