Plasmid Mediated mcr-1.1 Colistin-Resistance in Clinical Extraintestinal Escherichia coli Strains Isolated in Poland

Piotr Majewski; Anna Gutowska; David G E Smith; Tomasz Hauschild; Paulina Majewska; Tomasz Hryszko; Dominika Gizycka; Boguslaw Kedra; Jan Kochanowicz; Jerzy Glowiński; Justyna Drewnowska; Izabela Swiecicka; Pawel T Sacha; Piotr Wieczorek; Dominika Iwaniuk; Anetta Sulewska; Radoslaw Charkiewicz; Katarzyna Makarewicz; Agnieszka Zebrowska; Slawomir Czaban; Piotr Radziwon; Jacek Niklinski; Elzbieta A Tryniszewska

doi:10.3389/fmicb.2021.547020

Plasmid Mediated mcr-1.1 Colistin-Resistance in Clinical Extraintestinal Escherichia coli Strains Isolated in Poland

Front Microbiol. 2021 Dec 10:12:547020. doi: 10.3389/fmicb.2021.547020. eCollection 2021.

Authors

Piotr Majewski¹, Anna Gutowska¹, David G E Smith², Tomasz Hauschild³, Paulina Majewska⁴, Tomasz Hryszko⁵, Dominika Gizycka¹, Boguslaw Kedra⁶, Jan Kochanowicz⁷, Jerzy Glowiński⁸, Justyna Drewnowska³, Izabela Swiecicka³, Pawel T Sacha¹, Piotr Wieczorek¹, Dominika Iwaniuk¹, Anetta Sulewska⁹, Radoslaw Charkiewicz⁹, Katarzyna Makarewicz⁴, Agnieszka Zebrowska⁴, Slawomir Czaban¹⁰, Piotr Radziwon^{4

11}, Jacek Niklinski⁹, Elzbieta A Tryniszewska¹

Affiliations

¹ Department of Microbiological Diagnostics and Infectious Immunology, Medical University of Białystok, Białystok, Poland.
² Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, United Kingdom.
³ Department of Microbiology, Institute of Biology, University of Białystok, Białystok, Poland.
⁴ Regional Centre for Transfusion Medicine, Białystok, Poland.
⁵ Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Białystok, Białystok, Poland.
⁶ Second Department of General and Gastroenterological Surgery, Medical University of Białystok, Białystok, Poland.
⁷ Department of Neurology, Medical University of Białystok, Białystok, Poland.
⁸ Department of Vascular Surgery and Transplantation, Medical University of Białystok, Białystok, Poland.
⁹ Department of Clinical Molecular Biology, Medical University of Białystok, Białystok, Poland.
¹⁰ Department of Anesthesiology and Intensive Care, Medical University of Białystok, Białystok, Poland.
¹¹ Department of Hematology, Medical University of Białystok, Białystok, Poland.

Abstract

Objectives: The growing incidence of multidrug-resistant (MDR) bacteria is an inexorable and fatal challenge in modern medicine. Colistin is a cationic polypeptide considered a "last-resort" antimicrobial for treating infections caused by MDR Gram-negative bacterial pathogens. Plasmid-borne mcr colistin resistance emerged recently, and could potentially lead to essentially untreatable infections, particularly in hospital and veterinary (livestock farming) settings. In this study, we sought to establish the molecular basis of colistin-resistance in six extraintestinal Escherichia coli strains. Methods: Molecular investigation of colistin-resistance was performed in six extraintestinal E. coli strains isolated from patients hospitalized in Medical University Hospital, Bialystok, Poland. Complete structures of bacterial chromosomes and plasmids were recovered with use of both short- and long-read sequencing technologies and Unicycler hybrid assembly. Moreover, an electrotransformation assay was performed in order to confirm IncX4 plasmid influence on colistin-resistance phenotype in clinical E. coli strains. Results: Here we report on the emergence of six mcr-1.1-producing extraintestinal E. coli isolates with a number of virulence factors. Mobile pEtN transferase-encoding gene, mcr-1.1, has been proved to be encoded within a type IV secretion system (T4SS)-containing 33.3 kbp IncX4 plasmid pMUB-MCR, next to the PAP2-like membrane-associated lipid phosphatase gene. Conclusion: IncX4 mcr-containing plasmids are reported as increasingly disseminated among E. coli isolates, making it an "epidemic" plasmid, responsible for (i) dissemination of colistin-resistance determinants between different E. coli clones, and (ii) circulation between environmental, industrial, and clinical settings. Great effort needs to be taken to avoid further dissemination of plasmid-mediated colistin resistance among clinically relevant Gram-negative bacterial pathogens.

Keywords: IncX4 plasmid; colistin-resistance; extraintestinal E. coli; mcr-1.1; plasmid.

Copyright © 2021 Majewski, Gutowska, Smith, Hauschild, Majewska, Hryszko, Gizycka, Kedra, Kochanowicz, Glowiński, Drewnowska, Swiecicka, Sacha, Wieczorek, Iwaniuk, Sulewska, Charkiewicz, Makarewicz, Zebrowska, Czaban, Radziwon, Niklinski and Tryniszewska.