Related Experiment Video

Updated: Feb 5, 2026

Using a Cyclic Ion Mobility Spectrometer for Tandem Ion Mobility Experiments
08:40

Using a Cyclic Ion Mobility Spectrometer for Tandem Ion Mobility Experiments

Published on: January 20, 2022

4.9K

Transmission of Mobile Colistin Resistance (mcr-1) by Duodenoscope

Erica S Shenoy1,2,3, Virginia M Pierce4,5,6, Maroya Spalding Walters7

  • 1Division of Infectious Diseases, Boston, Massachusetts.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 12, 2018
PubMed
Abstract

Insights

Healthcare-associated transmission of mcr-1 bacteria occurred in the US via duodenoscope, despite adherence to infection control. Duodenoscope design flaws facilitate spread of multidrug-resistant organisms, necessitating improved colistin resistance detection.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Healthcare Epidemiology

Background:

  • Polymyxins are crucial for treating multidrug-resistant gram-negative bacterial infections.
  • Emergence of mobile colistin resistance genes (mcr) poses a significant threat for rapid spread of polymyxin resistance.
  • Investigating transmission routes of mcr-harboring bacteria is critical for infection control.

Purpose of the Study:

  • To investigate the potential transmission of Klebsiella pneumoniae carrying the mcr-1 gene via duodenoscope.
  • To report the first documented instance of healthcare transmission of mcr-1-harboring bacteria in the United States.
  • To identify contributing factors to the spread of multidrug-resistant organisms through medical devices.

Main Methods:

  • Conducted a field investigation including screening high-risk groups.
  • Performed genome sequencing of isolated mcr-1-positive Klebsiella pneumoniae.
  • Evaluated the duodenoscope for potential breaches and contamination, including biomaterial intrusion under the distal cap.

Main Results:

  • Identified highly related mcr-1-positive K. pneumoniae in two patients, with a duodenoscope as the sole epidemiological link.
  • Klebsiella pneumoniae and Escherichia coli were recovered from the duodenoscope, though neither harbored mcr-1.
  • Duodenoscope evaluation revealed biomaterial intrusion under the distal cap, leading to device recalls.

Conclusions:

  • Documented transmission of mcr-1 in a US hospital likely occurred via duodenoscope, irrespective of standard infection control practices.
  • Persistent duodenoscope design flaws contribute to the transmission of multidrug-resistant organisms.
  • Enhanced clinical laboratory capacity for colistin susceptibility testing is urgently needed to combat the spread of mcr-carrying bacteria.
Keywords:
Klebsiella pneumoniaeduodenoscopeinfection controlmedical device safetymobile colistin resistance

More Related Videos

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings19:57

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

19.3K
Paradigms for Pharmacological Characterization of C. elegans Synaptic Transmission Mutants18:01

Paradigms for Pharmacological Characterization of C. elegans Synaptic Transmission Mutants

Published on: August 18, 2008

14.7K

Related Concept Videos

Resistivity01:22

Resistivity

When a voltage is applied to a conductor, an electrical field is generated, and charges in the conductor feel the force due to the electrical field. The current density that results depends on the electrical field and the properties of the material. In some materials, including metals at a given temperature, the current density is approximately proportional to the electrical field. In these cases, the current density can be modeled as:
4.6K
Resistance01:19

Resistance

When a current moves through any conductor, the conductor causes some level of difficulty for the current to flow. The measure of that difficulty is known as the resistance of the material and is represented by R. Every material has its own resistance. In the case of conductors, heat is emitted whenever a current passes through them. Resistance depends on the resistivity of the material. Resistivity is a characteristic of the material used to fabricate electrical components, whereas the...
6.0K
Equivalent Resistance01:16

Equivalent Resistance

In circuit analysis, situations often arise where resistors are neither in series nor parallel configurations. To tackle such scenarios, three-terminal equivalent networks like the wye (Y) (Figure 1 (a)) or tee (T) and delta (Δ) (Figure 1 (b)) or pi (π) networks come into play. These networks offer versatile solutions and are frequently encountered in various applications, including three-phase electrical systems, electrical filters, and matching networks.
987
Resistance and Conductance01:25

Resistance and Conductance

A conductor's DC resistance at a given temperature is influenced by its resistivity, length, and cross-sectional area. Resistivity is an inherent property of the conductor material, with annealed copper serving as the international standard for measurement. For instance, the resistivity of hard-drawn aluminum at 20 degrees Celsius is 61% of the standard conductivity of annealed copper.
Various factors impact the resistance of a conductor. Spiraling in stranded conductors increases their...
517
Design of Transmission Shafts01:16

Design of Transmission Shafts

The design of a transmission shaft is governed by two primary specifications: the power it transmits and its rotational speed. These parameters guide the selection of the shaft's material and cross-sectional dimensions, ensuring that the material's maximum shearing stress remains within the elastic limit while transmitting the desired power at the given speed. The system's power is intrinsically linked to the applied torque. The torque applied to the shaft can be calculated by reconfiguring the...
789
Transmission Line Design Considerations01:23

Transmission Line Design Considerations

Aluminum has become the material of choice for overhead transmission lines, surpassing copper due to its abundance and cost-effectiveness. The most prevalent type is the aluminum conductor, steel-reinforced (ACSR), which combines aluminum strands around a steel core. Other variants include all-aluminum conductors (AAC), all-aluminum alloy conductors (AAAC), aluminum conductor alloy-reinforced (ACAR), and aluminum-clad steel conductors. Advanced designs, such as aluminum conductors with steel...
631