<i>mcr-1</i>–Positive Colistin-Resistant<i>Escherichia coli</i>in Traveler Returning to Canada from China

Payne, Michael; Croxen, Matthew A.; Lee, Tracy D.; Mayson, Brian; Champagne, Sylvie; Leung, Victor; Bariso, Sherri; Hoang, Linda; Lowe, Christopher J.

doi:10.3201/eid2209.160177

Cited by 42 publications

(28 citation statements)

References 9 publications

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“…Similarly, a case of mcr-1 -positive ST-3944 E. coli isolates cultured from the urine of a patient undergoing a prostate resection was believed to have been acquired in China 2 months prior, where the patient had been hospitalized for acute urinary retention (6). In our study, epidemiological data indicated that the patient most likely acquired the mcr-1 -carrying E.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Serial Isolates of mcr-1 -Positive Escherichia coli Reveals a Highly Active IS Apl1 Transposon

Snesrud

Ong

Corey

et al. 2017

Antimicrob Agents Chemother

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The emergence of a transferable colistin resistance gene (mcr-1) is of global concern. The insertion sequence ISApl1 is a key component in the mobilization of this gene, but its role remains poorly understood. Six Escherichia coli isolates were cultured from the same patient over the course of 1 month in Germany and the United States after a brief hospitalization in Bahrain for an unconnected illness. Four carried mcr-1 as determined by real-time PCR, but two were negative. Two additional mcr-1-negative E. coli isolates were collected during follow-up surveillance 9 months later. All isolates were analyzed by whole-genome sequencing (WGS). WGS revealed that the six initial isolates were composed of two distinct strains: an initial ST-617 E. coli strain harboring mcr-1 and a second, unrelated, mcr-1-negative ST-32 E. coli strain that emerged 2 weeks after hospitalization. Follow-up swabs taken 9 months later were negative for the ST-617 strain, but the mcr-1-negative ST-32 strain was still present. mcr-1 was associated with a single copy of ISApl1, located on a 64.5-kb IncI2 plasmid that shared >95% homology with other mcr-1 IncI2 plasmids. ISApl1 copy numbers ranged from 2 for the first isolate to 6 for the final isolate, but ISApl1 movement was independent of mcr-1. Some movement was accompanied by gene disruption, including the loss of genes encoding proteins involved in stress responses, arginine catabolism, and l-arabinose utilization. These data represent the first comprehensive analysis of ISApl1 movement in serial clinical isolates and reveal that, under certain conditions, ISApl1 is a highly active IS element whose movement may be detrimental to the host cell.

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Section: Discussionmentioning

confidence: 99%

Analysis of Serial Isolates of mcr-1 -Positive Escherichia coli Reveals a Highly Active IS Apl1 Transposon

Snesrud

Ong

Corey

et al. 2017

Antimicrob Agents Chemother

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“…Similarly, colistin resistance with the mobilized colistin resistance-1 (mcr-1) gene is a very concerning development. From its likely origin in China, mcr-1 has been detected in returned travelers around the world [86,87]. Like NDM-1, it can colonize travelers returning from endemic areas [88], and local transmission is now being seen outside of China [89].…”

Section: Antimicrobial Resistancementioning

confidence: 99%

Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel

Findlater

Bogoch

2018

Trends in Parasitology

227

168

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Greater human mobility, largely driven by air travel, is leading to an increase in the frequency and reach of infectious disease epidemics. Air travel can rapidly connect any two points on the planet, and this has the potential to cause swift and broad dissemination of emerging and re-emerging infectious diseases that may pose a threat to global health security. Investments to strengthen surveillance, build robust early-warning systems, improve predictive models, and coordinate public health responses may help to prevent, detect, and respond to new infectious disease epidemics.

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“…In humans, the earliest identified mcr-1 was found in a Shigella sonnei isolate arising from a hospitalized child with diarrhea in Vietnam in 2008 141 . Bacteria harboring mcr-1 have also been reported in isolates from humans (both infected patients and asymptomatic human carriers) in Canada 142 , 143 , China 108 , 136 , 144 – 154 , Denmark 106 , 140 , Ecuador 155 , Egypt 156 , France 130 , 157 , Germany 137 , 158 , 159 , Hong Kong 159 , 160 , India 161 , 162 , Italy 159 , 163 – 165 , Laos 130 , Malaysia 159 , 166 , Netherlands 131 , 167 – 170 , Norway 171 , Poland 159 , 172 , Portugal 173 , Russia 159 , Saudi Arabia 174 , Singapore 175 , 176 , South Africa 177 , 178 , Spain 159 , 179 , Sweden 180 , 181 , Switzerland 182 – 185 , Taiwan 186 , Thailand 130 , 187 , United Arab Emirates 174 , UK 188 , US 159 , 189 – 191 , Venezuela 192 , and Vietnam 141 ,…”

Section: Colistinmentioning

confidence: 99%

Illustrative examples of probable transfer of resistance determinants from food animals to humans: Streptothricins, glycopeptides, and colistin

Webb

Angulo

Granier³

et al. 2017

F1000Res

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Use, overuse, and misuse of antimicrobials contributes to selection and dissemination of bacterial resistance determinants that may be transferred to humans and constitute a global public health concern. Because of the continued emergence and expansion of antimicrobial resistance, combined with the lack of novel antimicrobial agents, efforts are underway to preserve the efficacy of current available life-saving antimicrobials in humans. As a result, uses of medically important antimicrobials in food animal production have generated debate and led to calls to reduce both antimicrobial use and the need for use. This manuscript, commissioned by the World Health Organization (WHO) to help inform the development of the WHO guidelines on the use of medically important antimicrobials in food animals, includes three illustrations of antimicrobial use in food animal production that has contributed to the selection—and subsequent transfer—of resistance determinants from food animals to humans. Herein, antimicrobial use and the epidemiology of bacterial resistance are described for streptothricins, glycopeptides, and colistin. Taken together, these historical and current narratives reinforce the need for actions that will preserve the efficacy of antimicrobials.

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mcr-1–Positive Colistin-ResistantEscherichia coliin Traveler Returning to Canada from China

Cited by 42 publications

References 9 publications

Analysis of Serial Isolates of mcr-1 -Positive Escherichia coli Reveals a Highly Active IS Apl1 Transposon

Analysis of Serial Isolates of mcr-1 -Positive Escherichia coli Reveals a Highly Active IS Apl1 Transposon

Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel

Illustrative examples of probable transfer of resistance determinants from food animals to humans: Streptothricins, glycopeptides, and colistin

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