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Molecular epidemiology of colistin-resistant Enterobacteriaceae in inpatient and avian isolates from China: high prevalence of mcr-negative Klebsiella pneumoniae

文献类型： 外文期刊

作者： Wang, Xiaojuan 1 ; Liu, Yuqing 2 ; Qi, Xiaomei 3 ; Wang, Ruobing 1 ; Jin, Longyang 1 ; Zhao, Min 2 ; Zhang, Yawei 1 ; Wan 1 ;

作者机构： 1.Peking Univ, Peoples Hosp, Dept Clin Lab, Beijing 100044, Peoples R China

2.Shandong Acad Agr Sci, Inst Anim Sci & Vet Med, Jinan, Shandong, Peoples R China

3.Peking Univ, Dept Clin Lab, Hosp Stomatol, Beijing, Peoples R China

4.Capital Med Univ, Beijing Anding Hosp, Clin Examinat & Expt Ctr, Beijing, Peoples R China

5.Capital Med Univ, Beijing Anding Hosp, Beijing, Peoples R China

关键词： Klebsiella pneumoniae;Escherichia coli;Colistin;MCR-1

期刊名称：INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS （ 影响因子：5.283； 五年影响因子：5.209 ）

ISSN： 0924-8579

年卷期： 2017 年 50 卷 4 期

页码：

收录情况： SCI

摘要： Whether chromosomal and transmissible mechanisms contribute simultaneously to colistin resistance in Klebsiella pneumoniae and Escherichia coli remains unknown. This study aims to identify the underlying mechanisms of colistin resistance in inpatient and avian K. pneumoniae and E. coli in China. We retrospectively screened 2353 Enterobacteriaceae isolates from inpatients at multiple centers during 20112014, and 168 avian isolates from one slaughterhouse in 2013 for the presence of MCR-1/MCR-2. Mutations and transcriptional levels of the chromosomal RamA, PhoPQ, and PmrAB genes were determined by PCR and RT-qPCR. The transferability and genetic characteristics of the underlying colistin-resistance genes were detected by conjugation and whole-genome sequencing. The MIC90 for colistin in colistin-resistant K. pneumoniae (ColRKP, 128 mg/L, N = 17) was 16-fold higher than in colistin-resistant E. coli (ColREC, 8mg/L, N = 33). The dominant sequence types of ColRKP were ST2018 and ST37, whereas ColREC displayed diversity. The chromosomal genes ramA, pmrB, and phoQ were not associated with colistin resistance in ColRKP. The transcriptional levels of PmrB in ColREC were 7.5-fold greater than in colistin-susceptible isolates. The carrying rates of MCR-1 in ColREC and ColRKP were 100% (33/33) and 23.5% (4/17), respectively. Plasmid IncI2 (similar to 60 kb) carrying MCR-1 could be transferred to recipient E. coli EC600 with frequencies ranging from 8.74 x 10(-6) to 1.31 x 10(-4). No transferable genes were identified in mcr-1-negative ColRKP. MCR-1 combined with upregulated PmrB was associated with low-level colistin resistance in ColREC. However, two-thirds of the ColRKP isolates were mcr-negative and need to be studied further. (C) 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

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