mcr-mediated colistin resistance in South America, a One Health approach: a review

Daza-Cardona, Erika Alexandra; Buenhombre, Jhon; Fontenelle, Raquel Oliveira dos Santos; Barbosa, Francisco César Barroso

doi:10.1097/mrm.0000000000000293

Cited by 4 publications

(3 citation statements)

References 92 publications

(139 reference statements)

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“…Based on our findings, colistin may be considered a significant therapeutic option for the treatment of CRE, but a prior susceptibility report may be needed. The mcr-1 gene was not detected in any of our isolates, in contrast with the results of other Latin American studies [34][35][36], suggesting that resistance could be mediated by chromosomal mutations or other mcr variants that were not studied and have been described in the region, including mcr-3 or mcr-5 [37][38][39]. Further studies are needed to understand the resistance mechanisms involved in colistin resistance.…”

Section: Discussioncontrasting

confidence: 88%

Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador

Soria-Segarra,

Molina-Matute

et al. 2024

BMC Infect Dis

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Introduction Carbapenem-resistant gram-negative bacilli are a worldwide concern because of high morbidity and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics and antimicrobial susceptibility profiles of carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022. Methods Ninety-five clinical isolates of carbapenem non-susceptible gram-negative bacilli were collected from six hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were screened for the blaKPC,blaNDM,blaOXA-48,blaVIM and blaIMP genes. In addition, A. baumannii isolates were screened for the blaOXA-23, blaOXA-58 and blaOXA-24/40 genes. Results Carbapenemase production was observed in 96.84% of the isolates. The blaKPC, blaNDM and blaOXA-48 genes were detected in Enterobacterales, with blaKPC being predominant. The blaVIM gene was detected in P. aeruginosa, and blaOXA-24/40 predominated in A. baumannii. Most of the isolates showed co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were active against carbapenem-resistant gram-negative bacilli that produce serin-carbapenemases. Conclusion The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase-producing K. pneumoniae harbouring blaKPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified, and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains.

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Section: Discussioncontrasting

confidence: 88%

Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador

Soria-Segarra,

Molina-Matute

et al. 2024

BMC Infect Dis

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“…IncFIB, IncFII, IncI2, IncI1, IncFIC, IncFIA, IncX1, and IncX4 were the plasmids with the highest occurrence in animal, human, food, and environmental samples. Moreover, these plasmids have been reported to be associated with HGT for mcr-1 variants and other ARGs ( Ghasemian et al, 2018 ; Daza-Cardona et al, 2022 ). Geographically, there is an apparent homogeneity in the presence of the plasmids IncFIB, IncFII, and IncI2.…”

Section: Resultsmentioning

confidence: 99%

Genomic insights of mcr-1 harboring Escherichia coli by geographical region and a One-Health perspective

Calero-Cáceres

Rodríguez²,

Medina³

et al. 2023

Front. Microbiol.

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The importance of the One Health concept in attempting to deal with the increasing levels of multidrug-resistant bacteria in both human and animal health is a challenge for the scientific community, policymakers, and the industry. The discovery of the plasmid-borne mobile colistin resistance (mcr) in 2015 poses a significant threat because of the ability of these plasmids to move between different bacterial species through horizontal gene transfer. In light of these findings, the World Health Organization (WHO) recommends that countries implement surveillance strategies to detect the presence of plasmid-mediated colistin-resistant microorganisms and take suitable measures to control and prevent their dissemination. Seven years later, ten different variants of the mcr gene (mcr-1 to mcr-10) have been detected worldwide in bacteria isolated from humans, animals, foods, the environment, and farms. However, the possible transmission mechanisms of the mcr gene among isolates from different geographical origins and sources are largely unknown. This article presents an analysis of whole-genome sequences of Escherichia coli that harbor mcr-1 gene from different origins (human, animal, food, or environment) and geographical location, to identify specific patterns related to virulence genes, plasmid content and antibiotic resistance genes, as well as their phylogeny and their distribution with their origin. In general, E. coli isolates that harbor mcr-1 showed a wide plethora of ARGs. Regarding the plasmid content, the highest concentration of plasmids was found in animal samples. In turn, Asia was the continent that led with the largest diversity and occurrence of these plasmids. Finally, about virulence genes, terC, gad, and traT represent the most frequent virulence genes detected. These findings highlight the relevance of analyzing the environmental settings as an integrative part of the surveillance programs to understand the origins and dissemination of antimicrobial resistance.

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“…A study conducted in São Paulo, Brazil on KPC-producing K. pneumoniae isolates demonstrated that the polymyxin resistance index varied from 0% in 2011 to 27% in 2015 42 - 44 . Some studies carried out in different Brazilian hospitals have identified strains of polymyxin-resistant enterobacteria, whose responsible mechanisms include modification of membrane LPS through inactivation of mgr B 17 and the presence of the mcr -1 gene 32 , 45 , 46 . Although reports of cases from the USA and Europe are generally rare, an increasing incidence from these regions has been recorded in recent years 47 , 48 .…”

Section: Introductionmentioning

confidence: 99%

Overview of polymyxin resistance in Enterobacteriaceae

Silva

Rossato

Leite

et al. 2022

Rev. Soc. Bras. Med. Trop.

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Polymyxin antibiotics are disfavored owing to their potential clinical toxicity, especially nephrotoxicity. However, the dry antibiotic development pipeline, together with the increasing global prevalence of infections caused by multidrug-resistant (MDR) gram-negative bacteria, have renewed clinical interest in these polypeptide antibiotics. This review highlights the current information regarding the mechanisms of resistance to polymyxins and their molecular epidemiology. Knowledge of the resistance mechanisms and epidemiology of these pathogens is critical for the development of novel antibacterial agents and rapid treatment choices.

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mcr-mediated colistin resistance in South America, a One Health approach: a review

Cited by 4 publications

References 92 publications

Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador

Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador

Genomic insights of mcr-1 harboring Escherichia coli by geographical region and a One-Health perspective

Overview of polymyxin resistance in Enterobacteriaceae

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