Colistin resistance in China: from outer membrane to One Health

2020 ◽  
Vol 20 (10) ◽  
pp. 1106-1108 ◽  
Author(s):  
Federico Perez ◽  
Robert A Bonomo
Keyword(s):  
Outer Membrane ◽  
One Health ◽  
Colistin Resistance

scholarly journals First Global Report of Plasmid-Mediated mcr-1 and Extended-Spectrum Beta-Lactamase-Producing Escherichia coli from Sheep in Portugal

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1403
Author(s):  
Josman Dantas Palmeira ◽  
Marisa Haenni ◽  
Jean-Yves Madec ◽  
Helena Maria Neto Ferreira
Keyword(s):  
One Health ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Colistin Resistance ◽  
Disk Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Beta Lactam Antibiotics ◽  
Extended Spectrum

Resistances to extended-spectrum cephalosporins (ESC) and colistin are One Health issues since genes encoding these resistances can be transmitted between all sectors of the One Health concept, i.e., human, animal, and the environment. Among food-producing animals, sheep farming has long been overlooked. To fill in this knowledge gap, we looked for ESC- and colistin resistance in 21 faecal samples collected from sheep in one farm in the south of Portugal. ESC-resistant isolates were selected on MacConkey agar plates supplemented with cefotaxime. Susceptibility testing was performed by the disk-diffusion method according to CLSI, while colistin MIC was determined by broth microdilution. ESC- and colistin-resistance genes were identified by PCR, and the clonality of all isolates was assessed by XbaI-PFGE. The replicon content was determined by PCR according to the PCR-based replicon typing (PBRT) scheme. Sixty-two non-duplicate ESC-resistant E. coli isolates were identified, which all presented an extended-spectrum beta-lactamase (ESBL) phenotype, mostly due to the presence of CTX-M genes. One CTX-M-1-producing E. coli was concomitantly colistin-resistant and presented the plasmid-mediated mcr-1 gene. Nearly all isolates showed associated resistances to non-beta-lactam antibiotics, which could act as co-selectors, even in the absence of beta-lactam use. The results showed a high proportion of ESBL-producing E. coli in sheep faeces. Their dissemination was very dynamic, with the spread of successful clones between animals, but also a large diversity of clones and plasmids, sometimes residing in the same animal. This study highlights the need for global surveillance in all food-producing sectors, in order to avoid the dissemination of genes conferring resistance to last-resort antibiotics in human medicine.

scholarly journals Klebsiella pneumoniae Complex Harboring mcr-1, mcr-7, and mcr-8 Isolates from Slaughtered Pigs in Thailand

2021 ◽  
Vol 9 (12) ◽  
pp. 2436
Author(s):  
Nattamol Phetburom ◽  
Parichart Boueroy ◽  
Peechanika Chopjitt ◽  
Rujirat Hatrongjit ◽  
Yukihiro Akeda ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Continuous Monitoring ◽  
One Health ◽  
Public Health Issue ◽  
Resistant Bacteria ◽  
Colistin Resistance ◽  
Amoxicillin Clavulanic Acid ◽  
Monitoring And Surveillance ◽  
Slaughtered Pigs

Dissemination of the mobile colistin resistance gene mcr in Enterobacterales among humans, animals, and the environment is a public health issue. We characterized mcr genes in the Klebsiella pneumoniae complex (KpnC) isolated from slaughtered pigs in Thailand. The 280 KpnCs consisted of K. pneumoniae (85%), Klebsiella quasipneumoniae (8.21%), and Klebsiella variicola (6.79%). mcr genes were detected in 6.79% (19/280) of KpnC isolates, consisting of mcr-8 (n = 9; 3.21%), mcr-7 (n = 7; 2.50%), mcr-7 + mcr-8 (n = 2; 0.71%), and mcr-1 + mcr-7 (n = 1; 0.36%). K. pneumoniae predominantly carried the mcr-7 and mcr-8 genes, while K. variicola and K. quasipneumoniae harbored mcr-7 and mcr-8, respectively. Six of the nineteen mcr-harboring KpnC isolates exhibited colistin resistance, and five had mcr-1 or mcr-8 transferable to an Escherichia coli recipient. Antimicrobial susceptibility analysis revealed that all mcr-carrying KpnC isolates were susceptible to carbapenems, cefotaxime, cefepime, amoxicillin/clavulanic acid, piperacillin/tazobactam, amikacin, and fosfomycin, and had high resistance to azithromycin. Multilocus sequence analysis demonstrated that the mcr-harboring KpnC isolates were genetically diverse. A ‘One-Health’ approach is useful to combat antimicrobial-resistant bacteria through coordinating the human, animal, and environmental sectors. Hence, continuous monitoring and surveillance of mcr-carrying KpnCs throughout the pork supply chain is crucial for ensuring public health.

scholarly journals Characterization of resistance mechanisms of Enterobacter cloacae Complex Co-resistant to Carbapenem and Colistin

2020 ◽  
Author(s):  
Tieli Zhou ◽  
Shixing Liu ◽  
Renchi Fang ◽  
Ying Zhang ◽  
Lijiang Chen ◽  
...  
Keyword(s):  
Membrane Protein ◽  
Outer Membrane ◽  
Lipid A ◽  
Efflux Pump ◽  
Medical Center ◽  
Resistance Mechanism ◽  
Carbapenem Resistance ◽  
Enterobacter Cloacae ◽  
Colistin Resistance ◽  
Carbapenemase Gene

Abstract Background: The emergence of carbapenem-resistant and colistin-resistant ECC pose a huge challenge to infection control. The purpose of this study was to clarify the mechanism of the carbapenems and colistin co-resistance in Enterobacter cloacae Complex (ECC) strains.Methods: Nineteen ECC isolates co-resistant to carbapenems and colistin were collected from a regional medical center in China. Carbapenemase gene, extended-spectrum β-lactamase gene, AmpC cephalosporinase gene ampC, mcr series genes, and ecr gene were detected by PCR. Expression levels of outer membrane protein OmpC/OmpF and efflux pump protein AcrA/AcrB were investigated. And the structural modification of lipid A of 19 ECC strains was analyzed.Results: This study showed that the mechanisms of carbapenem resistance in this study are: 1. Generating carbapenemase (7 of 19); 2. The production of AmpC or ESBLs combined with decreased expression of out membrane protein (12 of 19). And the mechanism of colistin resistance is increaseing expression of acrA in the efflux pump AcrAB-TolC alone (5 of 19) or accompanied by a decrease of affinity between colistin and outer membrane caused by the modification of lipid A (14 of 19). Moreover, an ECC strain co-harboring plasmid-mediated mcr-4.3 and blaNDM-1 has been found.Conclusions: This study suggested that there is no overlap between the resistance mechanism of co-resistant ECC strains to carbapenem and colistin. However, the emergence of strain co-harboring plasmid-mediated resistance genes indicated that ECC is a potential carrier for the horizontal spread of carbapenems and colistin resistance.

scholarly journals Phenotypic and genotypic resistance to colistin in E. coli isolated from wild boar (Sus scrofa) hunted in Italy

2021 ◽  
Vol 67 (3) ◽  
Author(s):  
Giovanni Cilia ◽  
Barbara Turchi ◽  
Filippo Fratini ◽  
Valentina Virginia Ebani ◽  
Luca Turini ◽  
...  
Keyword(s):  
Wild Boar ◽  
One Health ◽  
Resistant Bacteria ◽  
Colistin Resistance ◽  
Genotypic Resistance ◽  
E Coli ◽  
Microdilution Method ◽  
Potential Reservoir ◽  
The One ◽  
Reported Data

AbstractThe One Health approach is not only focused on diseases and zoonosis control but also on antimicrobial resistance. As concern this important issue, the problem of plasmid-mediated colistin resistance recently emerged. Few studies reported data about colistin resistance and mcr genes in bacteria from wildlife. In this manuscript, 168 Escherichia coli isolated from hunted wild boar were tested; colistin resistance was evaluated by MIC microdilution method, and the presence of mcr-1 and mcr-2 genes was evaluated by PCR. Overall, 27.9% of isolates resulted resistant to colistin, and most of them showed a MIC value > 256 μg/mL. A percentage of 44.6% of tested E. coli scored positive for one or both genes. In details, 13.6% of isolated harbored mcr-1 and mcr-2 in combination; most of them exhibiting the highest MIC values. Interestingly, 19.6% of mcr-positive E. coli resulted phenotypically susceptible to colistin. Wild boar could be considered a potential reservoir of colistin-resistant bacteria. In the light of the possible contacts with domestic animals and humans, this wild species could play an important role in the diffusion of colistin resistance. Thus, the monitoring programs on wildlife should include this aspect.

scholarly journals Colistin resistance in Escherichia coli confers protection of the cytoplasmic but not outer membrane from the polymyxin antibiotic

Microbiology ◽  
2021 ◽  
Vol 167 (11) ◽  
Author(s):  
Madeleine Humphrey ◽  
Gerald J. Larrouy-Maumus ◽  
R. Christopher D. Furniss ◽  
Despoina A. I. Mavridou ◽  
Akshay Sabnis ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Outer Membrane ◽  
Type Species ◽  
Cytoplasmic Membrane ◽  
Resistance Mechanisms ◽  
Bacterial Survival ◽  
Colistin Resistance ◽  
Content Type ◽  
E Coli ◽  
Link Type

Colistin is a polymyxin antibiotic of last resort for the treatment of infections caused by multi-drug-resistant Gram-negative bacteria. By targeting lipopolysaccharide (LPS), the antibiotic disrupts both the outer and cytoplasmic membranes, leading to bacterial death and lysis. Colistin resistance in Escherichia coli occurs via mutations in the chromosome or the acquisition of mobilized colistin-resistance (mcr) genes. Both these colistin-resistance mechanisms result in chemical modifications to the LPS, with positively charged moieties added at the cytoplasmic membrane before the LPS is transported to the outer membrane. We have previously shown that MCR-1-mediated LPS modification protects the cytoplasmic but not the outer membrane from damage caused by colistin, enabling bacterial survival. However, it remains unclear whether this observation extends to colistin resistance conferred by other mcr genes, or resistance due to chromosomal mutations. Using a panel of clinical E. coli that had acquired mcr −1, –1.5, −2, –3, −3.2 or −5, or had acquired polymyxin resistance independently of mcr genes, we found that almost all isolates were susceptible to colistin-mediated permeabilization of the outer, but not cytoplasmic, membrane. Furthermore, we showed that permeabilization of the outer membrane of colistin-resistant isolates by the polymyxin is in turn sufficient to sensitize bacteria to the antibiotic rifampicin, which normally cannot cross the LPS monolayer. These findings demonstrate that colistin resistance in these E. coli isolates is due to protection of the cytoplasmic but not outer membrane from colistin-mediated damage, regardless of the mechanism of resistance.

scholarly journals Community-Acquired Antimicrobial Resistant Enterobacteriaceae in Central America: A One Health Systematic Review

2020 ◽  
Vol 17 (20) ◽  
pp. 7622
Author(s):  
Lauren O’Neal ◽  
Danilo Alvarez ◽  
Renata Mendizábal-Cabrera ◽  
Brooke M. Ramay ◽  
Jay Graham
Keyword(s):  
Systematic Review ◽  
Central America ◽  
One Health ◽  
Carbapenem Resistance ◽  
Generation Cephalosporin ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Colistin Resistance ◽  
Extended Spectrum Beta Lactamase ◽  
Cephalosporin Resistance

Community-acquired antimicrobial resistant Enterobacteriaceae (CA-ARE) are an increasingly important issue around the world. Characterizing the distribution of regionally specific patterns of resistance is important to contextualize and develop locally relevant interventions. This systematic review adopts a One Health framework considering the health of humans, animals, and the environment to describe CA-ARE in Central America. Twenty studies were identified that focused on antimicrobial resistance (AMR) in Enterobacteriaceae. Studies on CA-ARE in Central America characterized resistance from diverse sources, including humans (n = 12), animals (n = 4), the environment (n = 2), and combinations of these categories (n = 2). A limited number of studies assessed prevalence of clinically important AMR, including carbapenem resistance (n = 3), third generation cephalosporin resistance (n = 7), colistin resistance (n = 2), extended spectrum beta-lactamase (ESBL) production (n = 4), or multidrug resistance (n = 4). This review highlights significant gaps in our current understanding of CA-ARE in Central America, most notably a general dearth of research, which requires increased investment and research on CA-ARE as well as AMR more broadly.

scholarly journals Colistin resistance in Escherichia coli confers protection of the cytoplasmic but not outer membrane from the polymyxin antibiotic

2021 ◽  
Author(s):  
Madeleine Humphrey ◽  
Gerald Larrouy-Maumus ◽  
Christopher Furniss ◽  
Despoina Mavridou ◽  
Akshay Sabnis ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Outer Membrane ◽  
Cytoplasmic Membrane ◽  
Resistance Mechanisms ◽  
Bacterial Survival ◽  
Colistin Resistance ◽  
E Coli ◽  
Cytoplasmic Membranes ◽  
Almost All ◽  
Chromosomal Mutations

Colistin is a polymyxin antibiotic of last resort for the treatment of infections caused by multi-drug resistant Gram-negative bacteria. By targeting lipopolysaccharide (LPS), the antibiotic disrupts both the outer and cytoplasmic membranes, leading to lysis and bacterial death. Colistin resistance in Escherichia coli occurs via mutations in the chromosome or the acquisition of mobilised colistin resistance (mcr) genes. Both these colistin resistance mechanisms result in chemical modifications to the LPS, with positively charged moieties added at the cytoplasmic membrane before the LPS is transported to the outer membrane. We have previously shown that MCR-1-mediated LPS modification protects the cytoplasmic but not the outer membrane from damage caused by colistin, enabling bacterial survival. However, it remains unclear whether this observation extends to colistin resistance conferred by other mcr genes, or resistance due to chromosomal mutations. Using a panel of clinical E. coli that had acquired mcr -1, -1.5, -2, -3, -3.2 or -5, or had acquired polymyxin resistance independently of mcr genes, we found that almost all isolates were susceptible to colistin-mediated permeabilisation of the outer, but not cytoplasmic, membrane. Furthermore, we showed that permeabilisation of the outer membrane of colistin resistant isolates by the polymyxin is in turn sufficient to sensitise bacteria to the antibiotic rifampicin, which normally cannot cross the LPS monolayer. These findings demonstrate that colistin resistance in E. coli is typically due to protection of the cytoplasmic but not outer membrane from colistin-mediated damage, regardless of the mechanism of resistance.

scholarly journals The Attenuated Protective Effect of Outer Membrane Vesicles Produced by a mcr-1 Positive Strain on Colistin Sensitive Escherichia coli

2021 ◽  
Vol 11 ◽  
Author(s):  
Xue Li ◽  
Lang Sun ◽  
Congran Li ◽  
Xinyi Yang ◽  
Xiukun Wang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Protective Effect ◽  
Outer Membrane ◽  
Lipid A ◽  
Membrane Vesicles ◽  
Outer Membrane Vesicles ◽  
Bacterial Cells ◽  
Colistin Resistance ◽  
E Coli ◽  
Positive Strain

Resistance to colistin, especially mobilized colistin resistance (mcr), is a serious threat to public health since it may catalyze a return of the “pre-antibiotic era”. Outer membrane vesicles (OMVs) play a role in antibiotic resistance in various ways. Currently, how OMVs participate in mcr-1-mediated colistin resistance has not been established. In this study, we showed that both OMVs from the mcr-1 negative and positive Escherichia coli (E. coli) strains conferred dose-dependent protection from colistin. However, OMVs from the mcr-1 positive strain conferred attenuated protection when compared to the OMVs of a mcr-1 negative strain at the same concentration. The attenuated protective effect of OMVs was related to the reduced ability to absorb colistin from the environment, thus promoting the killing of colistin sensitive E. coli strains. Lipid A modified with phosphoethanolamine was presented in the OMVs of the mcr-1 positive E. coli strain and resulted in decreased affinity to colistin and less protection. Meanwhile, E. coli strain carrying the mcr-1 gene packed more unmodified lipid A in OMVs and kept more phosphoethanolamine modified lipid A in the bacterial cells. Our study provides a first glimpse of the role of OMVs in mcr-1 -mediated colistin resistance.

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

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Erika Alexandra Daza-Cardona ◽  
Jhon Buenhombre ◽  
Raquel Oliveira dos Santos Fontenelle ◽  
Francisco Cesar Barroso Barbosa
Keyword(s):  
South America ◽  
One Health ◽  
Colistin Resistance
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