Purpose
The multiple-drug resistant
Escherichia coli
are among the deadliest pathogens causing life-threatening infections. This study was planned to determine the molecular epidemiology of
mcr-1, bla
KPC-2
, and
bla
NDM-1
harboring clinically isolated
E. coli
from Pakistan.
Methods
In total, 545 strains of
E. coli
from clinical samples were collected from June 2018 to September 2019. All the isolates were screened for colistin-resistance, extended-spectrum-β-lactamases (ESBL), and carbapenemases through the micro-dilution method, Double-Disk-Synergy-Test (DDST), and Modified-Hodge-Test (MHT). The detection, sequence-typing, conjugal transfer, S1-PFGE, plasmid-replicon-typing, and southern-blotting for
mcr
, ESBL, and carbapenemase-encoding genes were performed.
Findings
A total of four (0.73%) colistin-resistant strains carrying alongside
mcr-1
and
bla
CTX-M-15
genes, three of these strains also had the
bla
TEM-1
gene. The presence of ESBL genes was detected in 139 (25.5%) isolates harboring
bla
CTXM-15
(74.82%),
bla
TEM
(34.53%),
bla
SHV
(28.06%) and
bla
OXA-1
(28.78%). In 129 carbapenemase-producers, 35.83% possessed
bla
NDM-1
, 26.67%
bla
KPC-2
, 8.3%
bla
OXA-48
, 25%
bla
VIM-1
, and 20.83%
bla
IMP-1
genes. The sequence typing revealed that
mcr-1
harboring isolates belonged to ST405, ST117, and ST156. Fifty percent of
bla
KPC-2
and 48.83% of
bla
NDM-1
were found on ST131 and ST1196, respectively. Two rare types of STs, ST7584, and ST8671 were also identified in this study. The
mcr-1
gene was located on Incl2 (60-kb) plasmid. The
bla
KPC-2
was present on (140-kb) IncH12, (100-kb) IncN, (90-kb) Incl1, while
bla
NDM-1
was located on (70-kb) IncFIIK, (140-kb) IncH12, (100-kb) IncN, (60-kb) IncA/C, and (45-kb) IncFII plasmids, which were successfully trans-conjugated. Among the plasmid types, the Incl1 carrying
bla
KPC-2
, IncH12 harboring
bla
KPC-2
and
bla
NDM-1
, and IncFIIK carrying
bla
NDM-1
...