Journal
MICROORGANISMS
Volume 9, Issue 4, Pages -Publisher
MDPI
DOI: 10.3390/microorganisms9040799
Keywords
colistin resistance; mcr-1; multidrug resistant uropathogenic E; coli; IncHI2 plasmid; whole genome sequencing; Egypt
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Funding
- Department of Microbiology and Immunology, Center for Microbiome and Genome Research
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The reintroduction of colistin led to the global spread of plasmid-mediated mobile colistin resistance genes, including mcr-1. A study in Egypt found colistin resistance in Escherichia coli from patients with urinary tract infections, with a double mechanism involving mcr-1 and amino acid substitutions. The mcr-1 gene may have originated from the unbanned use of colistin in Egyptian agriculture, highlighting the need for proactive regulations to prevent further dissemination of this resistance.
The reintroduction of colistin, a last-resort antibiotic for multidrug-resistant pathogens, resulted in the global spread of plasmid-mediated mobile colistin resistance (mcr) genes. Our study investigated the occurrence of colistin resistance among Escherichia coli isolated from patients with urinary tract infections admitted to a teaching hospital in Egypt. Out of 67 isolates, three isolates were colistin-resistant, having a minimum inhibitory concentration of 4 mu g/mL and possessing the mcr-1 gene. A double mechanism of colistin resistance was detected; production of mcr-1 along with amino acid substitution in PmrB (E123D and Y358N) and PmrA (G144S). Broth mating experiments inferred that mcr-1 was positioned on conjugative plasmids. Whole-genome sequencing of EC13049 indicated that the isolate belonged to O23:H4-ST641 lineage and to phylogroup D. The mcr-1-bearing plasmid corresponded to IncHI2 type with a notable similarity to other E. coli plasmids previously recovered from Egypt. The unbanned use of colistin in the Egyptian agriculture sector might have created a potential reservoir for the mcr-1 gene in food-producing animals that spread to humans. More proactive regulations must be implemented to prevent further dissemination of this resistance. This is the first characterization of mcr-1-carrying IncHI2:ST4 plasmid recovered from E. coli of a clinical source in Egypt.
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