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22.11.2019 | Original Paper

Bloodstream infections caused by Escherichia coli carrying mcr-1 gene in hospitalized patients in northern Italy from 2012 to 2018

verfasst von: Bianca Mariani, Marta Corbella, Cristina Merla, Monica Tallarita, Antonio Piralla, Alessia Girello, Michele Castelli, Chiara Bracchi, Piero Marone, Patrizia Cambieri

Erschienen in: Infection | Ausgabe 2/2020

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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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Titel: Bloodstream infections caused by Escherichia coli carrying mcr-1 gene in hospitalized patients in northern Italy from 2012 to 2018
verfasst von: Bianca Mariani
Marta Corbella
Cristina Merla
Monica Tallarita
Antonio Piralla
Alessia Girello
Michele Castelli
Chiara Bracchi
Piero Marone
Patrizia Cambieri
Publikationsdatum: 22.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Infection / Ausgabe 2/2020
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-019-01377-4

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Bloodstream infections caused by Escherichia coli carrying mcr-1 gene in hospitalized patients in northern Italy from 2012 to 2018

Abstract

Purpose

Methods

Results

Conclusions

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