Detection of the plasmid-mediatedmcr-1gene conferring colistin resistance in human and food isolates ofSalmonella entericaandEscherichia coliin England and Wales

Doumith, Michel; Godbole, Gauri; Ashton, Philip; Larkin, Lesley; Dallman, Tim; Day, Martin; Day, Michaela; Müller‐Pebody, Berit; Ellington, Matthew J.; Pinna, Elizabeth de; Johnson, Alan P.; Hopkins, Katie L.; Woodford, Neil

doi:10.1093/jac/dkw093

Cited by 248 publications

(205 citation statements)

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“…and K. pneumoniae. 9,12,23,24 Mulvey and colleagues 32 have previously reported on the presence of the mcr-1 gene among E. coli in Canada. They screened about 1600 isolates from Canadian sources and identified 3 E. coli isolates that were mcr-1-positive: 1 was recovered from a clinical specimen in 2011, and 2 were recovered from lean ground beef in 2010.…”

Section: Discussionmentioning

confidence: 99%

Frequency of MCR-1-mediated colistin resistance among Escherichia coli clinical isolates obtained from patients in Canadian hospitals (CANWARD 2008-2015)

et al. 2016

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Background: Colistin is often used as an antimicrobial of last resort for the treatment of infections caused by multidrug-resistant gram-negative bacilli. In 2015, plasmid-mediated colistin resistance in Escherichia coli due to MCR-1 was described. The purpose of this study was to evaluate the frequency of colistin resistance among E. coli clinical isolates obtained from patients in Canadian hospitals as part of the Canadian Ward Surveillance Study (CANWARD) and to determine how often the mcr-1 gene is detected among the colistin-resistant subset. Methods:From January 2008 to December 2015 (excluding 2011), 10 to 15 sentinel hospitals submitted consecutive clinical isolates (1 per patient per infection site) from blood (100-240), respiratory (100-150), urine (25-100) and wound (25-100) infections. We performed susceptibility testing using Clinical and Laboratory Standards Institute broth microdilution methods. Isolates that showed resistance to colistin as defined by European Committee on Antimicrobial Susceptibility Testing breakpoints (minimum inhibitory concentration ≥ 4 µg/mL) were evaluated for the mcr-1 gene by polymerase chain reaction. Results:In total, 5571 E. coli clinical isolates were obtained over the study years. Twelve isolates (0.2%) were resistant to colistin. The proportion of colistin-resistant isolates varied from 0.0% to 0.5% depending on the study year, and there was no clear trend toward increasing resistance over time. Typically the colistin-resistant isolates remained susceptible to antimicrobials from several other classes. Two colistin-resistant isolates (0.04%) were found to harbour the mcr-1 gene. Interpretation:The results suggest that colistin resistance among E. coli human clinical isolates, including resistance mediated by the mcr-1 gene, remains rare in Canada. AbstractResearch Research CMAJ OPEN E642CMAJ OPEN, 4(4)to MCR-1. MCR-1 (encoded for by the mcr-1 gene) is a member of the phosphoethanolamine transferase enzyme family. It confers resistance to colistin by the transfer of phosphoethanolamine to lipid A, thereby reducing the affinity of the target (by reducing the negative charge) for this polycationic antimicrobial. 7 E. coli isolates with the mcr-1 gene typically have colistin minimum inhibitory concentrations (MICs) in the range of 4 to 8 µg/mL. 7-11The location of the mcr-1 gene on a plasmid is concerning, as this raises the possibility that the resistance determinant may be transferred to multidrug-resistant gram-negative bacteria. Indeed, the mcr-1 gene has already been detected in multidrugresistant E. coli isolates that also contain an extended-spectrum β-lactamase or a carbapenemase enzyme.12-15 Plasmid-mediated colistin resistance attributed to a second mcr gene (mcr-2) has also recently been described. 16 Many clinical microbiology laboratories do not test colistin routinely against E. coli, so the frequency with which resistance occurs in Canada is difficult to estimate from local data. The purpose of this study was to evaluate the frequency of colistin res...

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Section: Discussionmentioning

confidence: 99%

Frequency of MCR-1-mediated colistin resistance among Escherichia coli clinical isolates obtained from patients in Canadian hospitals (CANWARD 2008-2015)

et al. 2016

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“…The disruption of the tra region may explain the defective conjugation ability of this plasmid. Notably, the presence of mcr-1 between duplicated ISApl1 insertion elements has so far only been observed in one human KPC-2-producing E. coli isolate in Germany and two IncHI2 plasmids isolated in the United Kingdom (4,10).…”

Section: 100r-ec Carried Resistance Genes For Aminoglycosides [Aadamentioning

confidence: 99%

“…These strains (especially Escherichia coli) have been isolated worldwide from humans (1,(3)(4)(5)(6)(7)(8)(9)(10), food-producing animals (4,6,(11)(12)(13)(14), the food chain (7,10,(15)(16)(17), and the environment (4,15). However, most of these studies searched for mcr-1 in previously stored extended-spectrum cephalosporinresistant Enterobacteriaceae (ESC-R-Ent) (8,12,13,15,17).…”

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confidence: 99%

Travelers Can Import Colistin-Resistant Enterobacteriaceae, Including Those Possessing the Plasmid-Mediated mcr-1 Gene

Bernasconi

Kuenzli

Pires

et al. 2016

Antimicrob Agents Chemother

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f Stool samples from 38 travelers returning from India were screened for extended-spectrum cephalosporin-and carbapenemresistant Enterobacteriaceae implementing standard selective plates. Twenty-six (76.3%) people were colonized with CTX-M or DHA producers, but none of the strains was colistin resistant and/or mcr-1 positive. Nevertheless, using overnight enrichment and CHROMagar Orientation plates supplemented with colistin, four people (10.5%) were found to be colonized with colistinresistant Escherichia coli. One cephalosporin-susceptible sequence type 10 (ST10) strain carried a 4,211-bp ISApl1-mcr-1-ISApl1 element in an IncHI2 plasmid backbone.

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“…Since the first report of plasmid pHNSHP45 carrying the mcr-1 gene (1), numerous retrospective studies have been performed worldwide to investigate the presence of this specific gene in strains isolated from environmental samples, food animals, food, and humans (2)(3)(4)(5)(6)(7)(8)(9)(10)(11), and the earliest evidence for its presence dates back to the 1980s (12). The mcr-1 gene was recently found to be carried by different plasmid replicon types, such as IncI2, IncHI2, IncP, IncFIP, and IncX4 (4,(13)(14)(15). Moreover, the mcr-1 gene variant mcr-1.2 and the novel colistin resistance gene mcr-2 were discovered in isolates in Italy and Belgium, respectively (16,17).…”

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confidence: 99%

MCR-1.6, a New MCR Variant Carried by an IncP Plasmid in a Colistin-Resistant Salmonella enterica Serovar Typhimurium Isolate from a Healthy Individual

Lü

Luo

et al. 2017

Antimicrob Agents Chemother

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In this study, we report a novel mcr-1 gene variant, named mcr-1.6, carried by an IncP plasmid in a colistin-resistant Salmonella enterica serovar Typhimurium isolate from a healthy person. Compared with mcr-1, the mcr-1.6 gene contains two single-nucleotide polymorphisms, one of which results in an arginine to histidine variation (Arg536¡His). The plasmid carrying the mcr-1.6 gene was designated pMCR1.6_P053 and is similar to a recently discovered mcr-1-bearing plasmid found in Klebsiella pneumoniae.

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Detection of the plasmid-mediatedmcr-1gene conferring colistin resistance in human and food isolates ofSalmonella entericaandEscherichia coliin England and Wales

Abstract: Analysis of WGS data allowed rapid confirmation of the presence of the plasmid-mediated colistin resistance gene mcr-1 in diverse genetic environments and plasmids. It has been present in E. coli and Salmonella spp. harboured by humans in England and Wales since at least 2012.

Cited by 248 publications

References 26 publications

Frequency of MCR-1-mediated colistin resistance among Escherichia coli clinical isolates obtained from patients in Canadian hospitals (CANWARD 2008-2015)

Frequency of MCR-1-mediated colistin resistance among Escherichia coli clinical isolates obtained from patients in Canadian hospitals (CANWARD 2008-2015)

Travelers Can Import Colistin-Resistant Enterobacteriaceae, Including Those Possessing the Plasmid-Mediated mcr-1 Gene

MCR-1.6, a New MCR Variant Carried by an IncP Plasmid in a Colistin-Resistant Salmonella enterica Serovar Typhimurium Isolate from a Healthy Individual

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