AI Article Synopsis
- The study investigates the rise of multi-drug resistant (MDR) E. coli strains that are resistant to colistin, an older antibiotic, focusing on the prevalence of the mcr-1 resistance gene among bloodstream infections in a hospital in Italy from 2012 to 2018.
- A total of 1557 blood samples were analyzed, revealing that 14 strains (0.90%) were colistin-resistant and harbored the mcr-1 gene, with the most common genetic type being ST10.
- The findings highlight the urgent need for monitoring colistin resistance to combat the growing threat of MDR pathogens, stressing the public health implications of these resistant bacteria in Italy.
Article Abstract
Purpose: The recurrence of multi-drug resistant (MDR) pathogens to the latest antibiotics and the limited development of new antibacterial agents have reduced the options for the treatment of severe infections. The reintroduction of old antibiotics, such as colistin, represents an effective strategy, since the latest antibiotics are over-consumed and ineffective against MDR pathogens. In 2015, Liu (Lancet Infect Dis 16:161-168, 2016) reported Escherichia coli (E. coli) isolates carrying plasmid-mediated colistin resistance gene mcr-1. The first of mcr-1 positive colistin-resistant (col-R) E. coli from a human blood culture was observed in 2012 in Latin America, while in Italy was reported for the first time by our center in 2016. The present study aimed to describe the prevalence of mcr-1 positive col-R strains in E. coli-related bloodstream infection among patients hospitalized in Fondazione IRCCS Policlinico San Matteo in Pavia, Italy, from 2012 to 2018, including the three cases already published.
Methods: All col-R E. coli strains isolated from blood cultures collected during the study period were analyzed. The minimal inhibitory concentration of colistin was determined using broth microdilution and detection of mcr-1 and mcr-2 genes was performed by PCR. The sequence type of E. coli mcr-1 positive was determined according to Multilocus sequence typing.
Results: Out of 1557 samples, 14 strains (0.90%) were col-R. and positive for the presence of the mcr-1 gene, with no mcr-2 detected. The most common ST was ST10 (n = 3), followed by ST410 (n = 2). The remaining strains exhibited different MLST profiles, indicating that they were genetically unrelated.
Conclusions: Proper reporting of the presence of mcr-1 genes is an essential component to anticipate the spread of colistin resistance. This public health issue is particularly alarming in Italy due to the consistent circulation of MDR bacteria.
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| http://dx.doi.org/10.1007/s15010-019-01377-4 | DOI Listing |
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