Plasmid-mediated mcr-1 gene in Acinetobacter baumannii and Pseudomonas aeruginosa: first report from Pakistan

Hameed, Fareeha; Khan, Muhammad Asif; Muhammad, Hafsah; Sarwar, Tahir; Bilal, Hazrat; Rehman, Tayyab

doi:10.1590/0037-8682-0237-2019

Cited by 88 publications

(89 citation statements)

References 34 publications

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“…This gene encodes a PetN transferase resulting in polymyxin resistance. Despite that, mcr has not been described in A. baumannii until recently in reports from Pakistan [206] and Brazil [216], probably highlighting the high tendency for spread and stressing the need to understand the actual status of global colistin resistance in this pathogen. Table 1.…”

Section: Polymyxinsmentioning

confidence: 99%

“…Polymyxin E, also known as colistin, is an old antibiotic belonging to the polymyxin family, first introduced in the 1950s; owing to its harmful effects on renal function, its use was banned by many countries [206]. Nevertheless, the rapid emergence of resistance in A. baumannii to multiple antibiotics, including carbapenems, has revived interest in the use of colistin.…”

Section: Polymyxinsmentioning

confidence: 99%

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Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen

2020

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Being a multidrug-resistant and an invasive pathogen, Acinetobacter baumannii is one of the major causes of nosocomial infections in the current healthcare system. It has been recognized as an agent of pneumonia, septicemia, meningitis, urinary tract and wound infections, and is associated with high mortality. Pathogenesis in A. baumannii infections is an outcome of multiple virulence factors, including porins, capsules, and cell wall lipopolysaccharide, enzymes, biofilm production, motility, and iron-acquisition systems, among others. Such virulence factors help the organism to resist stressful environmental conditions and enable development of severe infections. Parallel to increased prevalence of infections caused by A. baumannii, challenging and diverse resistance mechanisms in this pathogen are well recognized, with major classes of antibiotics becoming minimally effective. Through a wide array of antibiotic-hydrolyzing enzymes, efflux pump changes, impermeability, and antibiotic target mutations, A. baumannii models a unique ability to maintain a multidrug-resistant phenotype, further complicating treatment. Understanding mechanisms behind diseases, virulence, and resistance acquisition are central to infectious disease knowledge about A. baumannii. The aims of this review are to highlight infections and disease-producing factors in A. baumannii and to touch base on mechanisms of resistance to various antibiotic classes.

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Section: Polymyxinsmentioning

confidence: 99%

Section: Polymyxinsmentioning

confidence: 99%

Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen

2020

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“…9 In addition to the known chromosomal-mediated resistance mechanisms, a plasmidmediated colistin resistance gene named mcr-1 was discovered in China and subsequently elsewhere around the world. 10 Carbapenemase producers, mainly nosocomial P. aeruginosa isolates, are usually MDR, and therapeutic options for treating infections with carbapenemase producers remain limited. 11 However, the sensitivity and specificity of phenotypic methods are less than molecular methods.…”

Section: Introductionmentioning

confidence: 99%

<p>Prevalence and Molecular Typing of Colistin-Resistant <em>Pseudomonas aeruginosa</em> (CRPA) Among β-Lactamase-Producing Isolates: A Study Based on High-Resolution Melting Curve Analysis Method</p>

Tahmasebi¹,

Dehbashi²,

Arabestani³

2020

IDR

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Background: The frequency and production of β-lactamase enzymes may be different in colistin-resistant Pseudomonas aeruginosa (CRPA) strains compared to susceptible strains. The purpose of this study was to investigate the relationship between colistin resistance and β-lactamase enzymes in different Sequence Types (ST) of P. aeruginosa. Methods: A total of 101 P. aeruginosa isolates were collected from different samples. The antimicrobial susceptibilities of the bacterial isolates were examined by disk diffusion and MIC E-test methods. Also, real-time PCR and high-resolution melting curve analysis (HRMA) assay were performed to detect the resistance genes. Results: Out of the 101 P. aeruginosa isolates, four isolates (3.96%) were resistant to colistin. Also, 39 isolates (38.61%) were considered as MDR, and eight isolates (7.92%) were considered as XDR. Further, 25 (24.75%) and 26 isolates (25.74%) were produced ESBL and carbapenemase enzymes, respectively. According to HRMA results, four isolates (3.96%) were positive for pmrA, three isolates (2.97%) were positive for mcr-1, 25 isolates (24.75%) were positive for blaTEM, 24 isolates (23.76%) were positive for blaSHV, 26 isolates (25.75%) were positive for blaKPC, and 23 isolates (22.77%) were positive for blaIMP genes. Furthermore, ST108 and ST250 showed the highest distribution in P. aeruginosa isolates. Also, ST217, ST1078, and ST3340 were reported as novel types in CRPA strains. Conclusion: Concerns about the prevalence of CRPA strains should be taken seriously. Also, our results showed that the mcr-1 gene plays a vital role in the distribution of ESBL and KPC-producing P. aeruginosa strains.

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“…In Pakistan, there is excessive use of colistin alone or in combination with other antibiotics for curing colibacillosis and clostridial enteritis in poultry (35). This increased use of colistin is directly related to the emergence of the mcr genes and resistance to colistin in bacterial isolates from poultry (14) and spread to humans through the food web (36,37). If the consumption of colistin continues to increase at the same pace, we will enter the post-antibiotic era with the widespread emerging resistance to colistin.…”

Section: Discussionmentioning

confidence: 99%

Detection of mcr-1 Gene in Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae From Human Urine Samples in Pakistan

Bilal

Hameed

Khan

et al. 2020

Jundishapur J Microbiol

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Background: Colistin is the last-resort antibiotic available to date against Multiple-drug-resistant (MDR) bacteria, particularly carbapenem-resistant Enterobacteriaceae (CRE) harboring the NDM 1 and KPC 2 genes. Objectives: The current study was designed to investigate extended-spectrum β-lactamase (ESBL) production, colistin resistance, and the presence of mcr-1 in Klebsiella pneumoniae isolated from urine samples. Methods: A total of 298 clinical isolates of K. pneumoniae were collected for seven months in 2017 from the main labs of three government tertiary care hospitals in Pakistan. The ESBL activity of the isolates was assessed by the Double Disc Synergy test (DDST). All the ESBL-producing isolates were phenotypically screened for colistin resistance by dilution methods. Colistin-resistant isolates were subjected to PCR for mcr-1 detection. The confirmation was done by the Sanger sequencing method. Results: Out of 298 K. pneumoniae isolates, 35 (11.7%) isolates showed ESBL activity. They were phenotypically screened for colistin resistance. Four (11.4%) colistin-resistant isolates out of 35 (11.7%) showed the minimum inhibitory concentrations (MICs) ranging from 4 mg/L to 8 mg/L. The mcr-1 gene was detected in all four colistin-resistant isolates via specific primers/PCR and confirmed by Sanger sequencing, showing 99% sequence similarity with the mcr-1 gene in GenBank. The sequence was submitted to NCBI GenBank, and an accession number was assigned. Conclusions: The presence of the mcr-1 gene in ESBL-producing bacteria isolated from human urine samples highlights the urgent need for surveillance studies on a larger scale to overcome the inappropriate use of colistin-containing formulations and prevent further spread of resistance to this antibiotic.

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Plasmid-mediated mcr-1 gene in Acinetobacter baumannii and Pseudomonas aeruginosa: first report from Pakistan

Cited by 88 publications

References 34 publications

Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen

Insights into Acinetobacter baumannii: A Review of Microbiological, Virulence, and Resistance Traits in a Threatening Nosocomial Pathogen

<p>Prevalence and Molecular Typing of Colistin-Resistant <em>Pseudomonas aeruginosa</em> (CRPA) Among β-Lactamase-Producing Isolates: A Study Based on High-Resolution Melting Curve Analysis Method</p>

Detection of mcr-1 Gene in Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae From Human Urine Samples in Pakistan

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