High Rates of Human Fecal Carriage of mcr-1–Positive Multidrug-Resistant Enterobacteriaceae Emerge in China in Association With Successful Plasmid Families

Zhong, Li-Ye; Phan, Hang; Cong, Shan; Vihta, Karina-Doris; Sheppard, Anna E.; Huang, Xi; Zeng, Kaiyang; Li, Hong Yu; Zhang, Xue Fei; Patil, Sandip; Crook, Derrick W.; Walker, A. Sarah; Xing, Yongzhong; Lin, J.; Feng, Lian; Doi, Yohei; Xia, Yong; Stoesser, Nicole; Tian, Guo‐Bao

doi:10.1093/cid/cix885

Cited by 65 publications

(48 citation statements)

References 50 publications

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“…In the present study, 21 colistin resistance mcr-1-carrying E. coli strains were detected from 2632 E. coli (0.80%; 21/2632) isolated from fecal samples, which was close to the 0.1-1% mcr-1 prevalence in Enterobacteriaceae isolates from clinical samples in previous investigations [11][12][13]. Compared with other fecal carriage data, the prevalence of colistin resistance in the present study was lower than that reported in Hongkong (2.08%), Guangzhou (6.2%), and Singapore (8.0%) [14][15][16]. This may be because the stool samples included in our study were obtained only from children.…”

Section: Discussionsupporting

confidence: 78%

“…Previous studies have shown that mcr-1 is present on many types of plasmids, such as IncI2, IncHI2, IncX4, etc. [14]. These plasmids often carry multiple drug resistance genes, such as β-lactamase gene (bla CTX−M , bla SHV−2 ), bla CMY−2 , etc., fosfomycin resistance gene fosA3, and quinolone resistance gene oqxAB [26,27], and can be transferred to a variety of clinically common host bacteria, such as Pseudomonas aeruginosa, K. pneumoniae, and E. coli, etc., threatening the treatment of drug-resistant gram-negative bacteria [3].…”

Section: Discussionmentioning

confidence: 99%

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Fecal Carriage and Molecular Epidemiology of mcr-1-Harboring Escherichia Coli from Children in Southern China.

Mai

Xiong

Yao

et al. 2020

Preprint

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Objective: The increase of multidrug resistant Enterobacteriaceae bacteria has led to reintroduction of colistin for clinical treatments, and colistin has become a last resort for infections caused by multidrug resistant bacteria. Enterobacteriaceae bacteria carrying the mcr-1 gene are majorly related to colistin resistance, which may be the main reason for continued increase in the colistin resistance rate of Enterobacteriaceae. The purpose of this study was to investigate the sequence type and prevalence of bacteria harboring mcr-1 gene in the gut flora of children in Southern China. Method: Fecal samples (n=2632) of children from 3 medical centers in Guangzhou were cultured for Escherichia coli (E. coli). The mcr-1-harboring isolates were screened by Polymerase chain reaction (PCR). The colistin resistance transfer frequency was studied by conjugation experiments. DNA sequencing of seven housekeeping genes were used for multi locus sequence typing analysis (MLST).Result: PCR indicated that 21 isolates from the 2632 E. coli (0.80%) were positive for mcr-1; these strains were resistant to colistin. Conjugation experiment indicated that 18 of the mcr-1-harboring isolates could transfer colistin resistance phenotypes to E. coli J53. MLST analysis revealed that the 21 isolates were divided into 18 sequence types (STs); ST69 was the most common (14.3%), followed by ST58 (9.5%). Conclusion: These results demonstrate the colonisation dynamics and molecular epidemiology of mcr-1-harboring E. coli in the gut flora of children in Southern China, and the mcr-1 gene can be horizontally transmitted within species, it is necessary to monitor the mcr-1-harboring bacteria in children.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Fecal Carriage and Molecular Epidemiology of mcr-1-Harboring Escherichia Coli from Children in Southern China.

Mai

Xiong

Yao

et al. 2020

Preprint

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“…38 In China, several studies focused on the carriage of MCR-producing strains. Zhong et al 39 reported a 6.2% mcr-1 prevalence from inpatients and outpatients of three hospitals, mainly corresponding to MDR E. coli. This prevalence was 1.6% in another study and rose to 9.8% when hospitalized children were targeted.…”

Section: Discussionmentioning

confidence: 98%

Colistin resistance in Parisian inpatient faecal Escherichia coli as the result of two distinct evolutionary pathways

Bourrel

Poirel

Royer

et al. 2019

Journal of Antimicrobial Chemotherapy

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Background: Beyond plasmid-encoded resistance (mcr genes) prevalence in strain collections, large epidemiological studies to estimate the human burden of colistin-resistant Escherichia coli gut carriage are lacking. Objectives: To evaluate the prevalence of colistin-resistant E. coli carriage in inpatients and decipher the molecular support of resistance and the genetic background of the strains. Methods: During a 3 month period in 2017, we prospectively screened patients in six Parisian hospitals for rectal carriage of colistin-resistant E. coli using a selective medium, a biochemical confirmatory test and MIC determination. WGS of the resistant strains and their corresponding plasmids was performed. Results: Among the 1217 screened patients, 153 colistin-resistant E. coli strains were isolated from 152 patients (12.5%). The mcr-1 gene was identified in only seven isolates (4.6%) on different plasmid scaffolds. The genetic background of these MCR-1 producers argued for an animal origin. Conversely, the remaining 146 colistinresistant E. coli exhibited a phylogenetic distribution corresponding to human gut commensal/clinical population structure (B2 and D phylogroup predominance); 72.6% of those isolates harboured convergent mutations in the PmrA and PmrB proteins, constituting a two-component system shown to be associated with colistin resistance. Conclusions: We showed that the occurrence at a high rate of colistin resistance in human faecal E. coli is the result of two distinct evolutionary pathways, i.e. the occurrence of chromosomal mutations in an endogenous E. coli population and the rare acquisition of exogenous mcr-1-bearing strains probably of animal origin. The involved selective pressures need to be identified in order to develop preventative strategies.

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“…The broad adaptation of colistin resistance all over the world could be due to the ease with which the mcr-1 gene integrates into various regions (Hadjadj et al, 2017). There is an association with successful plasmid families (Matamoros et al, 2017;Zhong et al, 2018). On the other hand, any association with clonal lineages of E. coli is described .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, pap2 gene and ISs IS26 and IS1924 were present in pLREC160_2. Zhong et al (2018) suggested that for IncX4 plasmids IS26/26 structures could be involved in mcr-1 gene mobilization. The BRIG comparison showed that the mcr-1-harboring IncX4 plasmids were genetically homologous between each other as previously described , suggesting that mobilization of the mcr-1 cassette was quite stable within this type of plasmids.…”

Section: Discussionmentioning

confidence: 99%

Whole Genome Sequencing and Characteristics of mcr-1–Harboring Plasmids of Porcine Escherichia coli Isolates Belonging to the High-Risk Clone O25b:H4-ST131 Clade B

et al. 2020

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High Rates of Human Fecal Carriage of mcr-1–Positive Multidrug-Resistant Enterobacteriaceae Emerge in China in Association With Successful Plasmid Families

Abstract: The high prevalence of mcr-1 in multidrug-resistant E. coli colonizing humans is a clinical threat; diverse genetic mechanisms (strains/plasmids/insertion sequences) have contributed to the dissemination of mcr-1, and will facilitate its persistence.

Cited by 65 publications

References 50 publications

Fecal Carriage and Molecular Epidemiology of mcr-1-Harboring Escherichia Coli from Children in Southern China.

Fecal Carriage and Molecular Epidemiology of mcr-1-Harboring Escherichia Coli from Children in Southern China.

Colistin resistance in Parisian inpatient faecal Escherichia coli as the result of two distinct evolutionary pathways

Whole Genome Sequencing and Characteristics of mcr-1–Harboring Plasmids of Porcine Escherichia coli Isolates Belonging to the High-Risk Clone O25b:H4-ST131 Clade B

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