Changes in colistin resistance and mcr-1 abundance in Escherichia coli of animal and human origins following the ban of colistin-positive additives in China: an epidemiological comparative study

Wang, Yang; Xu, Chunyan; Zhang, Rong; Chen, Yiqiang; Shen, Yingbo; Hu, Fupin; Liu, Dejun; Lu, Jiayue; Guo, Yan; Xia, Xi; Jiang, Junyao; Wang, Xueyang; Fu, Yulin; Lü, Yang; Wang, Jiayi; Li, Juan; Cai, Chang; Yin, Daqiang; Che, Jie; Fan, Ruixin; Wang, Yongqiang; Qi, Yan; Li, Yang; Liao, Kang; Chen, Hui; Zou, Ming-Xiang; Liang, Liang; Tang, Jin; Shen, Zhangqi; Wang, Shaolin; Yang, Xiaorong; Wu, Congming; Xu, Shaofa; Walsh, Timothy R.; Shen, Jianzhong

doi:10.1016/s1473-3099(20)30149-3

Cited by 256 publications

(232 citation statements)

References 26 publications

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“…Accumulated evidence showed that banning of colistin in animal feed efficiently restricted mcr-1 prevalence, not only in animals but also in humans and the whole ecosystem in China [2][3][4]. However, our previous study showed that a low proportion of Escherichia coli carrying chromosomally-encoded mcr-1 continually existed in the ecosystem [4], which was sporadically reported by other studies as well [9][10][11].…”

Section: Short Reportmentioning

confidence: 62%

“…The emergence and rapid dissemination of plasmidmediated mobile colistin resistance gene (mcr-1) have become a severe threat to public health [1]. The predominant carriers of mcr-1 were IncX4, IncI2, and IncHI2 plasmids, which are transferable and adaptive plasmid types with broad host range and contributed to the spread of mcr-1 among various sources and bacterial species [2][3][4]. Besides, recombination of transposons, especially Tn6330 (ISApl1-mcr-1-pap2-ISApl1), the primary vehicle for transmission of mcr-1, and phage-like sequences enable mcr-1 to transfer across plasmids and isolates.…”

Section: Short Reportmentioning

confidence: 99%

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Genomic patterns and characterizations of chromosomally-encoded mcr-1 in Escherichia coli populations

Cong

Zhong

et al. 2020

Gut Pathog

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The emergence and transmission of the mobile colistin resistance gene (mcr-1) threatened the extensive use of polymyxin antimicrobials. Accumulated evidence showed that the banning of colistin additive in livestock feed efficiently reduce mcr-1 prevalence, not only in animals but also in humans and environments. However, our previous study has revealed that a small proportion of Escherichia coli could continually carry chromosomally-encoded mcr-1. The chromosomally-encoded events, indicated the existence of stabilized heritage of mcr-1 and revealed a potential threat in the antimicrobial stewardship interventions, are yet to be investigated. In this study, we systematically investigated the genetic basis of chromosomally-encoded mcr-1 in prevalence and potential mechanisms of lineage, plasmid, insertion sequence, and phage. Our results demonstrated that the emergence of chromosomally-encoded mcr-1 could originate from multiple mechanisms, but mainly derived through the recombination of ISApl1/Tn6330. We reported a specific transmission mechanism, which is a phage-like region without lysogenic components, could associate with the emergence and stabilization of chromosomally-encoded mcr-1. These results highlighted the potential origin and risks of chromosomally-encoded mcr-1, which could be a heritable repository and thrive again when confronted with new selective pressures. To the best of our knowledge, this is the first study to systematically reveal the genomic basis of chromosomally-encoded mcr-1, and report a specific transmission pattern involved in phage-like region. Overall, we demonstrate the origin mechanisms and risks of chromosomally-encoded mcr-1. It highlights the need of public attention on chromosome-encoded mcr-1 to prevent from its reemergence.

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Section: Short Reportmentioning

confidence: 62%

Section: Short Reportmentioning

confidence: 99%

Genomic patterns and characterizations of chromosomally-encoded mcr-1 in Escherichia coli populations

Cong

Zhong

et al. 2020

Gut Pathog

Self Cite

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“…The self-reported colistin use is especially concerning as it is a last-line antimicrobial for Gram-negative infections in human patients. Previous widespread use of colistin in animal agriculture propagated resistant bacterial infections in humans and animals, leading to its ban in many countries, including India and China [17][18][19]. The lack of AMR knowledge and judicious use, particularly regarding drugs of high consequence, may further perpetuate its development in food animals and humans in Nepal.…”

Section: Discussionmentioning

confidence: 99%

Policy implications for awareness gaps in antimicrobial resistance (AMR) and antimicrobial use among commercial Nepalese poultry producers

Lambrou

Innes

O’Sullivan

et al. 2021

glob health res policy

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Background Nepal’s poultry industry has increased with a growing middle class, which has translated to an increase in antimicrobial consumption and thus a rise in antimicrobial resistance (AMR). Describing and understanding antimicrobial use practices among commercial poultry producers in Nepal may help minimize the risks of AMR development in both humans and animals and determine the effectiveness of relevant policies. Methods From July to August 2018, poultry farmers were randomly recruited from Nepal’s Chitwan District to participate in a cross-sectional study. The lead producer in each poultry operation was administered a quantitative structured-survey via a 30-min interview. Participants were asked to provide demographics, production practices, and knowledge about their antimicrobial use practices. Descriptive data analysis was performed to obtain frequencies and compare practices. Results In total, 150 commercial poultry producers of whom raised between 300 and 40,000 birds completed the interviews. Only 33% (n = 49) of producers reported knowing what AMR was, and among them only 50% (n = 25) consulted a veterinarian for treatment options. Antimicrobial administration for growth promotion was still employed by 13% of poultry producers. Similarly, critically important antimicrobial drugs, specifically colistin, were identified at 35% of participating operations. Producers reported low overall understanding and compliance of withdrawal periods (n = 41; 27%), which may result in both AMR development and adverse health reactions among consumers who ingest antimicrobial residues. Although Nepal has publicized antimicrobial use policies and awareness campaigns to instill healthy production practices, most producers (82%) were unaware of them. Conclusion Many Nepalese poultry producers lack overall antimicrobial use and AMR awareness, which is evidenced by low antimicrobial withdrawal period compliance, use of antimicrobials for growth promotion, and the sustained use of critically important antimicrobials. Improved outreach and educational capacities, paired with increased veterinary resources and extensive monitoring in operations and retail meat products, may increase AMR awareness and policy enforcement.

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“…Although challenges exist, the One Health approach has been repeatedly employed to mitigate animal and human disease threats, as exemplified by the 2017 response to colistin resistant E. coli (CREC) in China ( Wang et al, 2020 ). Colistin is used predominantly in the livestock sector but is an important antimicrobial of last resort for human disease.…”

Section: Integrating Health and Agri-food Policy As A Tool Against Outbmentioning

confidence: 99%

Moving health to the heart of agri-food policies; mitigating risk from our food systems

Patterson

Thomas

Coyne

et al. 2020

Global Food Security

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Our food systems are progressively more industrialized and consolidated with many modern food value chains involving multiple countries and continents, and as such being associated with changes in risk profile and impacts of emerging and re-emerging diseases. Disease outbreaks that sweep through a single region can have massive impacts on food supply, while severe outbreaks of human pathogens can disrupt agricultural labor supply or demand for products perceived as ‘unsafe’. Market pressures have generally rewarded production of cash crops for fuel and energy dense, low nutrient processed foods over production of fruits and vegetables for local consumption. Climbing rates of food-related NCDs and pre-existing conditions leave the population increasingly susceptible to infectious diseases that are often driven by or arise from the food system. Therefore disease and diet from our food systems cause impacts on human health, and human health issues can impact on the functioning of the food system. The COVID-19 outbreak is the most recent example of food system driven disease emergence and of massive supply and demand shocks in the food system, experienced as a direct and indirect result of this disease. The effects of the food system on disease spread (and vice versa) must be addressed in future plans to prevent and mitigate large scale outbreaks. Health policies must acknowledge the food system as the base of our health system, as must agri-food policy recognize the pre-eminence of human health (directly and indirectly) in decision making.

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Changes in colistin resistance and mcr-1 abundance in Escherichia coli of animal and human origins following the ban of colistin-positive additives in China: an epidemiological comparative study

Cited by 256 publications

References 26 publications

Genomic patterns and characterizations of chromosomally-encoded mcr-1 in Escherichia coli populations

Genomic patterns and characterizations of chromosomally-encoded mcr-1 in Escherichia coli populations

Policy implications for awareness gaps in antimicrobial resistance (AMR) and antimicrobial use among commercial Nepalese poultry producers

Moving health to the heart of agri-food policies; mitigating risk from our food systems

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