Plasmid-mediated mcr-1 in carbapenem-susceptible Escherichia coli ST156 causing a blood infection: an unnoticeable spread of colistin resistance in Brazil?

Clinics (Sao Paulo). 2017 Oct;72(10):642-644. doi: 10.6061/clinics/2017(10)09.

Abstract

Objective: We describe an IncX4 pHC891/16mcr plasmid carrying mcr-1 in a colistin-resistant and carbapenem-susceptible E. coli isolate (HC891/16), ST156, which caused a blood infection in a Brazilian patient with gallbladder adenocarcinoma.

Methods: Strain HC891/16 was subjected to whole genome sequencing using the MiSeq Platform (Illumina, Inc., USA). Assembly was performed using Mira and ABACAS.

Results: The isolates showed resistance only to ciprofloxacin, ampicillin and cefoxitin, and whole-genome sequencing revealed the presence of aac(6')Ib-cr and blaTEM1.

Conclusion: Our findings warn of the possible silent dissemination of colistin resistance by carbapenem-susceptible mcr-1 producers, as colistin susceptibility is commonly tested only among carbapenem-resistant isolates.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Bacteremia / drug therapy*
  • Brazil
  • Carbapenems / pharmacology*
  • Colistin / pharmacology*
  • Drug Resistance, Multiple, Bacterial
  • Escherichia coli / drug effects*
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Proteins / drug effects*
  • Escherichia coli Proteins / genetics
  • Escherichia coli Proteins / isolation & purification
  • Female
  • Humans
  • Microbial Sensitivity Tests
  • Plasmids / drug effects

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Escherichia coli Proteins
  • MCR-1 protein, E coli
  • Colistin