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Plasmid-mediated colistin resistance in Escherichia coli from the Arabian Peninsula

Ágnes Sonnevend1, Akela Ghazawi1, Manaf Alqahtani2

  • 1Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|August 28, 2016
PubMed
Abstract

Insights

The mcr-1 gene, conferring resistance to colistin, was found in multidrug-resistant Enterobacteriaceae from clinical samples across the Arabian Peninsula. This discovery highlights the potential for antibiotic use to drive the spread of resistance genes.

Area of Science:

  • Microbiology
  • Genetics
  • Infectious Diseases

Background:

  • Colistin is a critical antibiotic for treating infections caused by multidrug-resistant Gram-negative bacteria.
  • The emergence and spread of the mcr-1 gene, which confers resistance to colistin, is a significant global health concern.
  • Enterobacteriaceae are common causes of human infections and can harbor antimicrobial resistance genes.

Purpose of the Study:

  • To investigate the presence of the mcr-1 gene in colistin-resistant Enterobacteriaceae isolates from clinical sources in the Arabian Peninsula.
  • To characterize the genetic features and antibiotic susceptibility of mcr-1 positive strains.
  • To determine the plasmid context of the mcr-1 gene and its potential for horizontal transfer.

Main Methods:

  • Polymerase chain reaction (PCR) was used to detect the mcr-1 gene in 75 colistin-resistant Enterobacteriaceae strains from Bahrain, Kuwait, Oman, Saudi Arabia, and the UAE.
  • mcr-1 positive isolates underwent genotyping, antibiotic susceptibility testing, and plasmid analysis.
  • Conjugation experiments and plasmid sequencing were performed to elucidate the genetic environment of the mcr-1 gene.

Main Results:

  • Four Escherichia coli isolates (from Bahrain, Saudi Arabia, and the UAE) carried the mcr-1 gene on conjugative plasmids.
  • These isolates belonged to globally recognized multidrug-resistant E. coli clones (ST648, ST224, ST68, ST131).
  • The mcr-1 gene was found on IncI2 plasmids in three strains and on a large IncHI2 plasmid in the fourth, with co-occurrence of other resistance genes including blaNDM-1 and blaCTX-M-64.

Conclusions:

  • This study reports for the first time the presence of the plasmid-mediated mcr-1 gene in diverse multidrug-resistant clinical Enterobacteriaceae isolates from the Arabian Peninsula.
  • The findings suggest that the use of common antibiotics may inadvertently promote the dissemination of mcr-1 carrying strains or plasmids.
  • The co-location of mcr-1 with other resistance genes on mobile genetic elements underscores the threat to effective antimicrobial therapy.
Keywords:
Escherichia coliMiddle-Eastcolistin resistancemcr-1multi-drug resistance

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