Background
The emergence of carbapenem and colistin co-resistant
Escherichia coli
poses a huge challenge to infection control. The purpose of this study was to clarify the mechanism of the carbapenems and colistin co-resistance in
E. coli
strains.
Methods
Antimicrobial susceptibility test was carried out by agar dilution methods and colistin resistance was confirmed by broth microdilution methods. Whole genome sequencing was carried out, and resistance genes, sequence types and virulence genes of carbapenems and colistin co-resistance
E. coli
isolates were analyzed.
Results
The results showed that among the 176 carbapenem-resistant
Enterobacteriaceae
strains, 5 multidrug resistant
E. coli
strains exhibiting coresistance to carbapenem and colistin. The main mechanism of 5
E. coli
strains in this study was generating carbapenem. Four
E. coli
strains were
mcr-
positive, while one
mcr
-negative strain had a new MgrB mutation. The
bla
NDM-5,
bla
CTX-M-65,
bla
OXA-10,
bla
TEM-1 and
mcr-1.1
genes were simultaneously detected in
E. coli
20IR1127 strain belonging to ST156 lineage. Other antimicrobial resistance genes encoding aminoglycosides-, sulfonamide-, chloramphenicol-, tetracyclines- and macrolides resistance were also detected.
Conclusion
The main mechanisms of carbapenem and colistin resistance were encoded by
bla
NDM
and
mcr1.1
, meanwhile
mgrB
mutations also contribute to colistin resistance. To our knowledge, this study is the first to report of
E. coli
ST156 strain in which the
bla
NDM-5
,
bla
CTX-M-65
,
bla
OXA-10
,
bla
TEM-1
and
mcr1.1
genes coexist. In addition, there is also an
E. coli
ST457 strain, which carries
bla
TEM-1
,
bla
NDM-9
,
bla
CTX-M-199
and is positive for
mcr1.1
gene.