Abstract
In 1997, the first SPM-1-positive Pseudomonas aeruginosa isolate (48-1997A) from a 4-year-old leukemic girl in San Paulo, Brazil, was characterized. blaSPM-1 was flanked by two ISCR elements, designated ISCR4, and probably transposes via a mechanism called rolling-circle replication (8). Reports of ISCR elements are continually being linked with antibiotic resistance, particularly β-lactamases in Gram-negative bacteria