Global impact of mcr-1-positive Enterobacteriaceae bacteria on "one health"

Area of Science:

• Microbiology and Infectious Diseases
• Antimicrobial Resistance
• Epidemiology

Background:

• Polymyxins (polymyxin B and colistin) are critical last-line antibiotics against multidrug-resistant (MDR) Gram-negative bacteria, including carbapenem-resistant Enterobacteriaceae (CRE).
• The emergence and spread of the plasmid-mediated colistin resistance gene, mcr-1, and its variants present a significant global health and agricultural challenge.

Purpose of the Study:

• To review the global prevalence and dissemination of mcr-1 positive isolates.
• To identify the sources of mcr-1 dissemination, including animal, human, and environmental origins.
• To discuss the primary mechanisms facilitating mcr-1 transmission among these reservoirs.

Main Methods:

• Systematic review of existing epidemiological studies on mcr-1 and MCR-1-producing Enterobacteriaceae.
• Analysis of data from diverse sources: food animals, pet animals, wildlife, healthy human populations, patients, farms, urban/rural communities, and natural environments.
• Synthesis of information on the transmission pathways of the mcr-1 gene.

Main Results:

• mcr-1 positive isolates have been detected across a wide range of sources globally, indicating extensive dissemination.
• Evidence points to interconnected transmission networks involving animals, humans, and various environmental settings.
• The review consolidates current understanding of the geographical spread and ecological distribution of mcr-1.

Conclusions:

• The widespread presence of mcr-1 necessitates urgent global strategies to curb its further dissemination.
• Understanding transmission mechanisms is crucial for developing effective interventions to preserve colistin efficacy.
• Continued surveillance across all sectors (animal, human, environment) is essential to monitor and control this public health threat.