The Microbiological Characteristics of Carbapenem-Resistant Enterobacteriaceae Carrying the mcr-1 Gene

doi:10.3390/jcm8020261

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Title:	The Microbiological Characteristics of Carbapenem-Resistant Enterobacteriaceae Carrying the mcr-1 Gene
Authors:	Chih-Wei Chen(陳志偉) Tang, Hung-Jen Chen, Chi-Chung Lu, Ying-Chen Chen, Hung-Jui Su, Bo-An Weng, Tzu-Chieh Chuang, Yin-Ching Lai, Chih-Cheng
Contributors:	Chi Mei Med Ctr, Dept Surg, Div Neurosurg Chia Nan Univ Pharm & Sci, Coll Sustainable Environm, Dept Occupat Safety & Hlth, Inst Ind Safety & Disaster Prevent Chi Mei Med Ctr, Dept Med Chi Mei Med Ctr, Dept Med Res Natl Chiayi Univ, Dept Food Sci Chi Mei Med Ctr, Dept Med, Tainan 736, Taiwan Chi Mei Med Ctr, Dept Intens Care Med, Tainan 736, Taiwan
Keywords:	antibiotic resistance carbapenem-resistant Enterobacteriaceae colistin Escherichia coli mcr-1
Date:	2019-02
Issue Date:	2020-07-29 13:47:47 (UTC+8)
Publisher:	MDPI
Abstract:	Objectives: This study aims to assess the prevalence of the mcr-1 gene among carbapenem-resistant Enterobacteriaceae (CRE) isolated from clinical specimens and to further investigate the clinical significance and microbiological characteristics of CRE carrying the mcr-1 gene. Methods: Four hundred and twenty-three CRE isolates were screened for the presence of the mcr-1 gene. After identification, their clinical significance, antibiotic susceptibility, and antibiotic resistance mechanisms including the ESBL gene, carbapenemase gene, outer membrane protein (OMP), and plasmid sequencing were assessed. Results: Only four (0.9%) isolates of carbapenem-resistant Escherichia coli (E. coli) were found to carry the mcr-1 gene and demonstrated different pulsed-field gel electrophoresis (PFGE) patterns and sequence types (ST). While one patient was considered as having mcr-1-positive carbapenem-resistant E. coli (CREC) colonization, the other three mcr-1-positive CREC-related infections were classified as nosocomial infections. Only amikacin and tigecycline showed good in vitro activity against these four isolates, and three of them had a minimum inhibitory concentration with colistin of >= 4 mg/L. In the colistin-susceptible isolate, mcr-1 was nonfunctional due to the insertion of another gene. In addition, all of the mcr-1-positive CREC contained various resistant genes, such as AmpC(CMY), bla(NDM), bla(TEM), bla(SHV), and bla(CTX). In addition, one strain (EC1037) had loss of the OMP. Conclusions: The emergence of the mcr-1 gene among CRE, especially E. coli, remains worth our attention due to its resistance to most antibiotics, and a further national survey is warranted.
Relation:	Journal of Clinical Medicine, v.8, n.2, 261
Appears in Collections:	[Dept. of Occupational Safety] Periodical Articles

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