mcr-1 and blaKPC-3 in Escherichia coli Sequence Type 744 after Meropenem and Colistin Therapy, Portugal

Tacão, Marta; Tavares, Rafael D.S.; Teixeira, Pedro; Roxo, Inês; Ramalheira, Elmano; Ferreira, Silvaneide; Henriques, Isabel

doi:10.3201/eid2308.170162

Cited by 37 publications

(27 citation statements)

References 10 publications

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“…The P3 site appears to have particular characteristics in terms of the resistome. In addition to the genes already mentioned above (i.e., bla IMP , bla VIM and bla CTX−M ), other clinically relevant genes have also been detected at this site, such as mcr-5 genes, which confer resistance to colistin and which have recently been detected in plasmids from environmental, human and animal derived isolates (Sun et al, 2017;Tacão et al, 2017;Chen et al, 2018). Furthermore, in this site, the diversity of resistance genes found was superior to that of the other two sites (Supplementary Table S4).…”

Section: Analysis Of the Resistomementioning

confidence: 89%

Resistome in Lake Bolonha, Brazilian Amazon: Identification of Genes Related to Resistance to Broad-Spectrum Antibiotics

et al. 2020

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Resistance to antibiotics is one of the most relevant public health concerns in the world. Aquatic environments play an important role because they are reservoirs for antibiotic resistance genes and antibiotic-resistant strains, contributing to the spread of resistance. The present study investigated the resistome in Lake Bolonha (three sampling sites) in the Amazon region using a metagenomics approach and culture-dependent methods. Whole-metagenome-based results showed that the most abundant phyla were Protobacteria, Actinobacteria, Firmicutes, Bacteroidetes and Cyanobacteria. The composition of the resistome demonstrated that the genes that confer resistance to β-lactams were prevalent at all sampling sites, followed by genes conferring resistance to aminoglycosides and tetracycline. Acquired genes encoding extended-spectrum β-lactamases (e.g., bla CTX−M) and resistance to carbapenems (e.g., bla IMP and bla VIM) were detected through metagenome analysis. Bacteria were isolated from culture medium supplemented with cefotaxime or imipenem, and isolates were identified and analyzed for their antibiotic susceptibility profiles and resistance genes. In total, 98 bacterial isolates belonging to the genera Pseudomonas (37), Acinetobacter (32), Klebsiella (13), Enterobacter (9), Pantoe (3), Stenotrophomonas (3), and Methylobacterium (1) were obtained. Among isolates, the most abundant genes were bla CTX−M (28.3%), bla SHV (22.6%) and bla TEM (18.8%) in isolates from cefotaximesupplemented medium and bla VIM (28.8%) and bla IMP (22.2%) in isolates recovered from imipenem-supplemented medium. The genes intl1 and intl2 were detected in 19.3% and 7.1% of isolates. Antibiograms showed that 94.9% (from cefotaxime-supplemented medium) and 85.7% (from imipenem-supplemented medium) of the isolates were multidrug resistant. Besides cefotaxime and imipenem, isolates were mostly resistant to aztreonam (91.8%), amoxicillin (98.8%), ampicillin (82.6%), and nalidixic acid (77.5%). Hence, the present study demonstrates that Lake Bolonha is a reservoir of bacteria resistant to antibiotics and resistance genes, some of which are of critical importance to human health.

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Section: Analysis Of the Resistomementioning

confidence: 89%

Resistome in Lake Bolonha, Brazilian Amazon: Identification of Genes Related to Resistance to Broad-Spectrum Antibiotics

et al. 2020

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“…The bla KPC-2 and bla NDM was responsible for phenotypic resistance in 58% and 32% of the CRE strains in China, respectively [2]. Co-existence of mcr genes and different carbapenem resistance genes such as bla KPC-3 , bla NDM-5 , and bla NDM-16 have been sporadically reported in Enterobacteriaceae isolated from patients from different continents, among which E. coli was the most reported hosts [44][45][46]. Consistently, all mcr-1-positive CRE strains in this study belonged to E. coli, indicating E. coli was the major reservoir of such resistance genes.…”

Section: Discussionmentioning

confidence: 99%

Colistin-resistance gene mcr in clinical carbapenem-resistant Enterobacteriaceae strains in China, 2014–2019

Huang

Dong

Shu

et al. 2020

Emerging Microbes & Infections

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To investigate whether introduction of colistin into the clinical settings selected colistin-resistant CRE, we performed molecular epidemiological study of 1868 CRE strains collected from different geographical locales in China during the period 2014-2019. 1755 (96.18%) isolates carried the carbapenemase genes bla KPC and bla NDM ; 14 Escherichia coli isolates (0.75%) carrying mcr-1 and bla NDM (MCR-CREC) were also identified. Importantly, the number and relative prevalence of MCR-CREC isolates increased from 5 (0.41%) to 9 (1.38%) after introduction of polymyxin into clinical practice. Consistently, results of genetic analysis indicated that MCR-CREC strains collected before December 2017 were genetically diverse, yet those collected after that date exhibited more closely related genetic profiles, indicating that specific MCR-CREC strains were rapidly selected as a result of increased usage of colistin in clinical settings. The resistance level of MCR-CREC isolates to colistin increased after the introduction of polymyxin into clinical use with the MIC to colistin from <2 mg/L in 80% strains to 2 mg/L in 100% strains. Further dissemination of MCR-CREC strains, which exhibit resistance to the last-line drugs of carbapenems and colistin, is expected to pose a severe threat to human health.

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“…In all mcr-1 –positive isolates, the gene was located in an IncX4-type plasmid ( Figure 2 ). Comparative genomics revealed that this plasmid (pAN_M1A) is circulating among diverse hosts (humans, pig, poultry) and the environment in many different countries, including Portugal ( 11 ). We identified bla KPC-3 in a Tn 4401d isoform in an ≈58-kb IncN-ST15 plasmid, a minority platform in our previous survey ( 5 ); bla CTX-M-15 was associated with multireplicon plasmid IncFII K -FIA-FIB.…”

Section: The Studymentioning

confidence: 99%

mcr-1 in Carbapenemase-Producing Klebsiella pneumoniae with Hospitalized Patients, Portugal, 2016–2017

Mendes¹,

Novais²,

Campos³

et al. 2018

Emerg. Infect. Dis.

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mcr-1 and bla_KPC-3 in Escherichia coli Sequence Type 744 after Meropenem and Colistin Therapy, Portugal

Cited by 37 publications

References 10 publications

Resistome in Lake Bolonha, Brazilian Amazon: Identification of Genes Related to Resistance to Broad-Spectrum Antibiotics

Resistome in Lake Bolonha, Brazilian Amazon: Identification of Genes Related to Resistance to Broad-Spectrum Antibiotics

Colistin-resistance gene mcr in clinical carbapenem-resistant Enterobacteriaceae strains in China, 2014–2019

mcr-1 in Carbapenemase-Producing Klebsiella pneumoniae with Hospitalized Patients, Portugal, 2016–2017

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