Global Burden of Colistin-Resistant Bacteria: Mobilized Colistin Resistance Genes Study (1980–2018)

Abstract

Colistin is considered to be an antimicrobial of last-resort for the treatment of multidrug-resistant Gram-negative bacterial infections. The recent global dissemination of mobilized colistin resistance (mcr) genes is an urgent public health threat. An accurate estimate of the global prevalence of mcr genes, their reservoirs and the potential pathways for human transmission are required to implement control and prevention strategies, yet such data are lacking. Publications from four English (PubMed, Scopus, the Cochrane Database of Systematic Reviews and Web of Science) and two Chinese (CNKI and WANFANG) databases published between 18 November 2015 and 30 December 2018 were identified. In this systematic review and meta-analysis, the prevalence of mcr genes in bacteria isolated from humans, animals, the environment and food products were investigated. A total of 974 publications were identified. 202 observational studies were included in the systematic review and 71 in the meta-analysis. mcr genes were reported from 47 countries across six continents and the overall average prevalence was 4.7% (0.1–9.3%). China reported the highest number of mcr-positive strains. Pathogenic Escherichia coli (54%), isolated from animals (52%) and harboring an IncI2 plasmid (34%) were the bacteria with highest prevalence of mcr genes. The estimated prevalence of mcr-1 pathogenic E. coli was higher in food-animals than in humans and food products, which suggests a role for foodborne transmission. This study provides a comprehensive assessment of prevalence of the mcr gene by source, organism, genotype and type of plasmid.

mcr-Colistin Resistance Genes Mobilized by IncX4, IncHI2, and IncI2 Plasmids in Escherichia coli of Pigs and White Stork in Spain

“…Plasmid mediated colistin resistance has been described worldwide in a variety of Enterobacterales of different origins, environment, food producing animals, wildlife and humans (Zurfluh et al, 2016;Guenther et al, 2017;Ovejero et al, 2017;Barlaam et al, 2019;Elbediwi et al, 2019;Lalaoui et al, 2019;Mendes Oliveira et al, 2019;Nang et al, 2019;Zając et al, 2019). In particular, in Spain, mcr-1 has been described circulating in pig farms for many years (Quesada et al, 2016;Garcia-Menino et al, 2018), and our results demonstrate its presence in pig farms in Spain as early as 2005.…”

“…The unique ST type shared between isolates of both origins was ST10. ST10 is widely disseminated in humans and animals and frequently associated not only with the presence of cephalosporin resistance genes (Ojer-Usoz et al, 2017), but currently also with the occurrence of mcr-1 (Matamoros et al, 2017;Elbediwi et al, 2019). In fact, two ST10 isolates of pig and white stork origin from our study exhibited co-resistance to colistin and cephalosporins, both critically important antimicrobials to treat severe human infections caused by MDR Gram-negative in hospital settings (World Health Organization [WHO], 2017).…”

“…However, mcr-1 has been isolated from enterobacteria of different origins, humans, livestock, wildlife, and the environment (Prim et al, 2016;Caltagirone et al, 2017;El Garch et al, 2018). Furthermore, in 90% of the cases, mcr-1 has been associated to IncX4, IncHI2, and IncI2 mobilizable plasmids (Matamoros et al, 2017;Elbediwi et al, 2019) facilitating its worldwide distribution (Li et al, 2017).…”

Genomic Characterization of New Variant of Hydrogen Sulfide (H2S)-Producing Escherichia coli with Multidrug Resistance Properties Carrying the mcr-1 Gene in China

“…The interesting point is that the cytoprotective effect of H 2 S is a universal defense mechanism found in bacteria as well as in mammals [2,4]. Moreover, the sequence type (ST) 10 E. coli strain is one of the predominant STs in the world [8]. Hemolysin/cytolysin A hlyE/clyA…”

Emerging colistin resistance in Salmonella enterica serovar Newport isolates from human infections

“…Since colistin is not officially allowed in Chinese aquaculture, the aquatic environment is liable to contamination through colistin-treated animal faeces via the use of manures in feeding farmed fish. It is likely that the polygenetic feature of S. Newport may expand its capability in mcr dissemination [20,21], and more importantly, global food chain may further facilitate the dissemination of foodborne pathogens and AR dissemination. Appropriate regulations for monitoring AR of the imported food are urgently needed, particularly, for regions with AR prevalence.…”