Abstract
A set of 908 clinically derived colistin-resistant Enterobacteriaeae isolates collected worldwide in 2014–2016 were screened for the presence of the plasmid-borne mcr-1, mcr-2, mcr-3, mcr-4 and mcr-5 genes. In total 3.2% (29/908) of the collection were positive for mcr, including 27 Escherichia coli, 1 Klebsiella pneumoniae and 1 Enterobacter cloacae. Twenty-four isolates possessed genes from the mcr-1 family, including the original mcr-1 (n = 22), as well as mcr-1.2 (n = 1) and mcr-1.5 (n = 1), which each differ from mcr-1 by encoding single amino acid variations. Genes from the mcr-3 family were found in isolates from Thailand, including mcr-3.1 (n = 3) and mcr-3.2 (n = 1). An E. coli isolated from a patient with a urinary tract infection in Colombia contained the recently discovered mcr-5. The full colistin-resistant collection was tested against a panel of antimicrobial agents with ceftazidime-avibactam and tigecycline exhibiting the highest activity.
Highlights
Use of colistin, which became clinically available in 1959, has historically played a minor role as an anti-infective therapy due to its nephrotoxicity, as well as the availability of alternative antimicrobial agents [1]
The discovery by Liu, et al [4] of the plasmid-borne phosphoethanolamine transferase resistance determinant mcr-1 revealed a mechanism for horizontal spread
Mcr was detected in 29 isolates (3.2%), and included 27 E. coli, 1 K. pneumoniae and 1 E. cloacae collected in 15 countries (Malaysia, 5; Thailand, 5; Spain, 3; Argentina, 2; Italy, 2; Colombia, 2; Germany, 2; Brazil, Hong Kong, Poland, Portugal, Russia, South Africa, Taiwan, and Venezuela, 1 each) as part of INFORM in 2014 (n = 14), 2015 (n = 11) and 2016 (n = 4) (Table 1)
Summary
Use of colistin, which became clinically available in 1959, has historically played a minor role as an anti-infective therapy due to its nephrotoxicity, as well as the availability of alternative antimicrobial agents [1]. To gain further insight into the global prevalence of mcr in enteric bacteria isolated from human clinical samples, colistin-resistant isolates from a large international surveillance study were examined for the presence of these genes. Mcr was detected in 29 isolates (3.2%), and included 27 E. coli, 1 K. pneumoniae and 1 E. cloacae collected in 15 countries (Malaysia, 5; Thailand, 5; Spain, 3; Argentina, 2; Italy, 2; Colombia, 2; Germany, 2; Brazil, Hong Kong, Poland, Portugal, Russia, South Africa, Taiwan, and Venezuela, 1 each) as part of INFORM in 2014 (n = 14), 2015 (n = 11) and 2016 (n = 4) (Table 1).
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