High Rates of Human Fecal Carriage of mcr-1–Positive Multidrug-Resistant Enterobacteriaceae Emerge in China in Association With Successful Plasmid Families
| Autor: | Derrick W. Crook, Yohei Doi, Hongyu Li, Kun Jiao Zeng, Xi Huang, Karina Doris Vihta, Jia lin Lin, Yong Xing, A. Sarah Walker, Hang T. T. Phan, Guo-Bao Tian, Sandip Patil, Yong Xia, Lian Qiang Feng, Anna E. Sheppard, Lan Lan Zhong, Cong Shen, Xue Fei Zhang, Nicole Stoesser |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) China Klebsiella pneumoniae 030106 microbiology Drug resistance Microbial Sensitivity Tests medicine.disease_cause Microbiology 03 medical and health sciences Feces Plasmid Bacterial Proteins Enterobacteriaceae Drug Resistance Multiple Bacterial medicine Escherichia coli Prevalence Humans Insertion sequence Articles and Commentaries biology Whole Genome Sequencing Colistin Escherichia coli Proteins Enterobacteriaceae Infections biology.organism_classification Virology Anti-Bacterial Agents Cephalosporins Infectious Diseases Carrier State MCR-1 hormones hormone substitutes and hormone antagonists medicine.drug Plasmids |
| Popis: | Objectives mcr-1-mediated colistin resistance in Enterobacteriaceae is concerning, as colistin is used in treating multidrug-resistant Enterobacteriaceae infections. Rates of human mcr-1 gastrointestinal carriage have historically been low. We identified trends in human fecal mcr-1-positivity rates and colonization with mcr-1-positive+third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae in Guangzhou, China, and investigated the genetic contexts of mcr-1 in a subset of mcr-1-positive+3GC-R strains. Methods Fecal samples were collected from in-patients and out-patients submitting specimens to three hospitals (2011-2016). mcr-1 carriage trends were assessed using iterative sequential regression. A subset of mcr-1-positive isolates was sequenced (whole genome sequencing [WGS], Illumina), and genetic contexts (flanking regions, plasmids) of mcr-1 characterized. Results Of 8,022 fecal samples collected, 497 (6.2%) were mcr-1-positive, and 182 (2.3%) harbored mcr-1-positive+3GC-R Enterobacteriaceae. We observed marked increases in mcr-1 (0% [Apr/2011] to 31% [Mar/2016]) and more recent (since January 2014; 0% [Apr/2011] to 15% [Mar/2016]) increases in human colonization with mcr-1-positive+3GC-R Enterobacteriaceae (p WGS of mcr-1-positive+3GC-R isolates (70 Escherichia coli, 3 Klebsiella pneumoniae) demonstrated bacterial strain diversity (48 E. coli sequence types); mcr-1 in association with common plasmid backbones (IncI, IncHI2/HI2A, IncX4) and sometimes in multiple plasmids; frequent mcr-1 chromosomal integration; and high mobility of the mcr-1-associated insertion sequence ISApl1. Sequence similarity with published mcr-1 plasmid sequences was consistent with spread amongst animal/human reservoirs. Conclusions 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. |
| Databáze: | OpenAIRE |
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