泰国人源耐粘菌素大肠埃希菌和肺炎克雷伯菌中 mcr-1 耐药基因的流行情况。

Prevalence of the colistin resistance gene mcr-1 in colistin-resistant Escherichia coli and Klebsiella pneumoniae isolated from humans in Thailand.

机构信息

Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.

Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand.

出版信息

J Glob Antimicrob Resist. 2018 Dec;15:32-35. doi: 10.1016/j.jgar.2018.06.007. Epub 2018 Jun 20.

DOI:10.1016/j.jgar.2018.06.007

PMID:29935331

Abstract

OBJECTIVES

Historically, colistin has been considered a last-line therapeutic option against multidrug-resistant Gram-negative bacterial infections. However, chromosomally-encoded and plasmid-mediated colistin resistance is increasingly being reported worldwide. Spread of the plasmid-borne colistin resistance gene mcr-1 is of great concern since it can be transferred between bacteria. The aim of this study was to investigate the prevalence of mcr-1 in Escherichia coli and Klebsiella pneumoniae collected from human clinical specimens in Thailand during 2014-2017.

METHODS

Minimum inhibitory concentrations (MICs) of colistin were determined by the broth microdilution method for 317 non-duplicate Enterobacteriaceae clinical isolates (37 E. coli and 280 K. pneumoniae). All isolates were screened for the mcr-1 gene by PCR.

RESULTS

The colistin MIC, MIC and MIC range for the 37 E. coli isolates were 0.5, 8 and 0.5-32mg/L, respectively. The mcr-1 gene was detected in 11 E. coli isolates (29.7%). Escherichia coli harbouring the mcr-1 gene had a colistin MIC range of 4-32mg/L. The colistin MIC, MIC, and MIC range for the 280 K. pneumoniae isolates were 32, >128, and 0.25 to >128mg/L, respectively. The mcr-1 gene was detected in 4 K. pneumoniae isolates (1.4%). Klebsiella pneumoniae harbouring the mcr-1 gene had a colistin MIC range of 4-64mg/L.

CONCLUSIONS

This is the first report on the prevalence of the mcr-1 gene in colistin-resistant E. coli and K. pneumoniae isolated from humans in Thailand. These data provide added insight into the mechanism of colistin resistance among Enterobacteriaceae pathogens.

摘要

目的

historically，多黏菌素被认为是治疗多重耐药革兰氏阴性菌感染的最后一线治疗选择。然而，全球范围内越来越多地报道了染色体编码和质粒介导的多黏菌素耐药。质粒携带的多黏菌素耐药基因 mcr-1 的传播令人担忧，因为它可以在细菌之间转移。本研究旨在调查 2014-2017 年期间从泰国人类临床标本中分离的大肠杆菌和肺炎克雷伯菌中 mcr-1 的流行情况。

方法

通过肉汤微量稀释法测定 317 株非重复肠杆菌科临床分离株（37 株大肠埃希菌和 280 株肺炎克雷伯菌）的多黏菌素最小抑菌浓度（MIC）。所有分离株均通过 PCR 筛选 mcr-1 基因。

结果

37 株大肠埃希菌分离株的多黏菌素 MIC、MIC 和 MIC 范围分别为 0.5、8 和 0.5-32mg/L。11 株大肠埃希菌（29.7%）检测到 mcr-1 基因。携带 mcr-1 基因的大肠埃希菌多黏菌素 MIC 范围为 4-32mg/L。280 株肺炎克雷伯菌的多黏菌素 MIC、MIC 和 MIC 范围分别为 32、>128 和 0.25 至>128mg/L。4 株肺炎克雷伯菌（1.4%）检测到 mcr-1 基因。携带 mcr-1 基因的肺炎克雷伯菌多黏菌素 MIC 范围为 4-64mg/L。