Prevalence, risk factors, outcomes, and molecular epidemiology of mcr-1 -positive Enterobacteriaceae in patients and healthy adults from China: an epidemiological and clinical study

Wang, Yang; Tian, Guo‐Bao; Zhang, Rong; Shen, Yingbo; Tyrrell, Jonathan M.; Huang, Xi; Zhou, Hongwei; Lei, Lei; Li, Hongyu; Doi, Yohei; Fang, Ying; Ren, Hongwei; Zhong, Lan-Lan; Shen, Zhangqi; Zeng, Kun-Jiao; Wang, Shaolin; Liu, Jianhua; Wu, Congming; Walsh, Timothy R.; Shen, Jianzhong

doi:10.1016/s1473-3099(16)30527-8

Cited by 308 publications

(251 citation statements)

References 23 publications

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“…This ST has been described by Overdevest et al as an E. coli clone associated with extended-spectrum beta-lactamase (ESBL) production that can colonise patients for prolonged periods, with an estimated half-life of 13 months [14] and by Wang et al as a prevalent ST in China probably associated with a high risk of dissemination among E. coli [6]. In our patient, the ST131 E. coli did not appear to be more pathogenic.…”

Section: Discussionmentioning

confidence: 54%

Three cases of mcr-1-positive colistin-resistant Escherichia coli bloodstream infections in Italy, August 2016 to January 2017

et al. 2017

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We describe three cases of bloodstream infection caused by colistin-resistant Escherichia coli in patients in a tertiary hospital in Italy, between August 2016 and January 2017. Whole genome sequencing detected the mcr-1 gene in three isolated strains belonging to different sequence types (STs). This occurrence of three cases with mcr-1-positive E. coli belonging to different STs in six months suggests a widespread problem in settings where high multidrug resistance is endemic such as in Italy.

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Section: Discussionmentioning

confidence: 54%

Three cases of mcr-1-positive colistin-resistant Escherichia coli bloodstream infections in Italy, August 2016 to January 2017

et al. 2017

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“…Since we first reported the mobile colistin resistance gene mcr-1 in China in 2016 (1), there have been reports of mcr-1 in Enterobacteriaceae isolated from animals, animal products, humans, and the environment in over 30 countries across five continents (2). More worrisome is the presence of mcr-1 in Enterobacteriaceae carrying carbapenem resistance genes, such as bla NDM and bla KPC , which would seriously compromise the treatment of infections caused by these extensively drug-resistant pathogens (2).…”

Section: Observationmentioning

confidence: 99%

Novel Plasmid-Mediated Colistin Resistance Gene mcr-3 in Escherichia coli

Yin

Shen

et al. 2017

mBio

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441

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The mobile colistin resistance gene mcr-1 has attracted global attention, as it heralds the breach of polymyxins, one of the last-resort antibiotics for the treatment of severe clinical infections caused by multidrug-resistant Gram-negative bacteria. To date, six slightly different variants of mcr-1, and a second mobile colistin resistance gene, mcr-2, have been reported or annotated in the GenBank database. Here, we characterized a third mobile colistin resistance gene, mcr-3. The gene coexisted with 18 additional resistance determinants in the 261-kb IncHI2-type plasmid pWJ1 from porcine Escherichia coli. mcr-3 showed 45.0% and 47.0% nucleotide sequence identity to mcr-1 and mcr-2, respectively, while the deduced amino acid sequence of MCR-3 showed 99.8 to 100% and 75.6 to 94.8% identity to phosphoethanolamine transferases found in other Enterobacteriaceae species and in 10 Aeromonas species, respectively. pWJ1 was mobilized to an E. coli recipient by conjugation and contained a plasmid backbone similar to those of other mcr-1-carrying plasmids, such as pHNSHP45-2 from the original mcr-1-harboring E. coli strain. Moreover, a truncated transposon element, TnAs2, which was characterized only in Aeromonas salmonicida, was located upstream of mcr-3 in pWJ1. This ΔTnAs2-mcr-3 element was also identified in a shotgun genome sequence of a porcine E. coli isolate from Malaysia, a human Klebsiella pneumoniae isolate from Thailand, and a human Salmonella enterica serovar Typhimurium isolate from the United States. These results suggest the likelihood of a wide dissemination of the novel mobile colistin resistance gene mcr-3 among Enterobacteriaceae and aeromonads; the latter may act as a potential reservoir for mcr-3.

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“…Diverse sequence types (STs) of mcr-1 -positive strains were identified among different regions, with some commonality in clades isolated from clinical samples, such as ST10 (Wang et al, 2017). Furthermore, ST10 has also been found in asymptomatic carriage of E. coli co-harboring bla NDM−1 and mcr-1 from a healthy individual (Zhong et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Decreased Fitness and Virulence in ST10 Escherichia coli Harboring blaNDM-5 and mcr-1 against a ST4981 Strain with blaNDM-5

Zhang

Liao

Gao

et al. 2017

Front. Cell. Infect. Microbiol.

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Although coexistence of blaNDM-5 and mcr-1 in Escherichia coli has been reported, little is known about the fitness and virulence of such strains. Three carbapenem-resistant Escherichia coli (GZ1, GZ2, and GZ3) successively isolated from one patient in 2015 were investigated for microbiological fitness and virulence. GZ1 and GZ2 were also resistant to colistin. To verify the association between plasmids and fitness, growth kinetics of the transconjugants were performed. We also analyzed genomic sequences of GZ2 and GZ3 using PacBio sequencing. GZ1 and GZ2 (ST10) co-harbored blaNDM-5 and mcr-1, while GZ3 (ST4981) carried only blaNDM-5. GZ3 demonstrated significantly more rapid growth (P < 0.001) and overgrew GZ2 with a competitive index of 1.0157 (4 h) and 2.5207 (24 h). Increased resistance to serum killing and mice mortality was also identified in GZ3. While GZ2 had four plasmids (IncI2, IncX3, IncHI2, IncFII), GZ3 possessed one plasmid (IncFII). The genetic contexts of blaNDM-5 in GZ2 and GZ3 were identical but inserted into different backbones, IncX3 (102,512 bp) and IncFII (91,451 bp), respectively. The growth was not statistically different between the transconjugants with mcr-1 or blaNDM-5 plasmid and recipient (P = 0.6238). Whole genome sequence analysis revealed that 28 virulence genes were specific to GZ3, potentially contributing to increased virulence of GZ3. Decreased fitness and virulence in a mcr-1 and blaNDM-5 co-harboring ST10 E. coli was found alongside a ST4981 strain with only blaNDM-5. Acquisition of mcr-1 or blaNDM-5 plasmid did not lead to considerable fitness costs, indicating the potential for dissemination of mcr-1 and blaNDM-5 in Enterobacteriaceae.

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Prevalence, risk factors, outcomes, and molecular epidemiology of mcr-1 -positive Enterobacteriaceae in patients and healthy adults from China: an epidemiological and clinical study

Abstract: National Key Basic Research Program of China, National Natural Science Foundation of China/Zhejiang, National Key Research and Development Program, and MRC, UK.

Cited by 308 publications

References 23 publications

Three cases of mcr-1-positive colistin-resistant Escherichia coli bloodstream infections in Italy, August 2016 to January 2017

Three cases of mcr-1-positive colistin-resistant Escherichia coli bloodstream infections in Italy, August 2016 to January 2017

Novel Plasmid-Mediated Colistin Resistance Gene mcr-3 in Escherichia coli

Decreased Fitness and Virulence in ST10 Escherichia coli Harboring blaNDM-5 and mcr-1 against a ST4981 Strain with blaNDM-5

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