[Antimicrobial resistance: is it really all going wrong now?]

Area of Science:

• Microbiology
• Genetics
• Public Health

Background:

• Plasmid-mediated colistin resistance, identified by the mcr-1 gene, emerged globally in 2015.
• The mcr-1 gene was found to be prevalent in animal and human reservoirs in China shortly after its discovery.

Purpose of the Study:

• To assess the global prevalence and history of the mcr-1 gene.
• To determine the implications of mcr-1 gene prevalence for clinical practices, particularly in the Netherlands.

Main Methods:

• Review of scientific literature and data up to January 2016.
• Analysis of bacterial isolate collections from human and animal sources across different continents.

Main Results:

• The mcr-1 gene has been present since at least 2005 and is not confined to a single plasmid.
• Demonstrated presence on four continents, with widespread prevalence in global animal reservoirs.
• Very low prevalence observed in human isolates.

Conclusions:

• The mcr-1 gene is a globally distributed resistance mechanism with a significant animal reservoir.
• Current findings do not necessitate changes in clinical management for Dutch patients.
• Continued surveillance of antimicrobial resistance is crucial.