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Plasmid-mediated mcr-1 colistin resistance in Escherichia coli and Klebsiella spp. clinical isolates from the Western Cape region of South Africa

dc.contributor.authorNewton-Foot, Maeen_ZA
dc.contributor.authorSnyman, Yolandien_ZA
dc.contributor.authorMaloba, Motlatji Reratilwe Bonnieen_ZA
dc.contributor.authorWhitelaw, Andrew Christopheren_ZA
dc.date.accessioned2017-08-07T05:59:33Z
dc.date.available2017-08-07T05:59:33Z
dc.date.issued2017-08-03
dc.identifier.citationNewton-Foot, M., Snyman, Y., Maloba, M. R. B. & Whitelaw, A. C. 2017. Plasmid-mediated mcr-1 colistin resistance in Escherichia coli and Klebsiella spp. clinical isolates from the Western Cape region of South Africa. Antimicrobial Resistance & Infection Control, 6:78, doi:10.1186/s13756-017-0234-8.
dc.identifier.issn2047-2994 (online)
dc.identifier.otherdoi:10.1186/s13756-017-0234-8
dc.identifier.urihttp://hdl.handle.net/10019.1/102058
dc.descriptionCITATION: Newton-Foot, M., Snyman, Y., Maloba, M. R. B. & Whitelaw, A. C. 2017. Plasmid-mediated mcr-1 colistin resistance in Escherichia coli and Klebsiella spp. clinical isolates from the Western Cape region of South Africa. Antimicrobial Resistance & Infection Control, 6:78, doi:10.1186/s13756-017-0234-8.
dc.descriptionThe original publication is available at https://aricjournal.biomedcentral.com
dc.description.abstractBackground: Colistin is a last resort antibiotic for the treatment of carbapenem-resistant Gram negative infections. Until recently, mechanisms of colistin resistance were limited to chromosomal mutations which confer a high fitness cost and cannot be transferred between organisms. However, a novel plasmid-mediated colistin resistance mechanism, encoded by the mcr-1 gene, has been identified, and has since been detected worldwide. The mcr-1 colistin resistance mechanism is a major threat due to its lack of fitness cost and ability to be transferred between strains and species. Surveillance of colistin resistance mechanisms is critical to monitor the development and spread of resistance.This study aimed to determine the prevalence of the plasmid-mediated colistin resistance gene, mcr-1, in colistin-resistant E. coli and Klebsiella spp. isolates in the Western Cape of South Africa; and whether colistin resistance is spread through clonal expansion or by acquisition of resistance by diverse strains. Methods: Colistin resistant E. coli and Klebsiella spp. isolates were collected from the NHLS microbiology laboratory at Tygerberg Hospital. Species identification and antibiotic susceptibility testing was done using the API® 20 E system and the Vitek® 2 Advanced Expert System™. PCR was used to detect the plasmid-mediated mcr-1 colistin resistance gene and REP-PCR was used for strain typing of the isolates. Results: Nineteen colistin resistant isolates, including 12 E. coli, six K. pneumoniae and one K. oxytoca isolate, were detected over 7 months from eight different hospitals in the Western Cape region. The mcr-1 gene was detected in 83% of isolates which were shown to be predominantly unrelated strains. Conclusions: The plasmid-mediated mcr-1 colistin resistance gene is responsible for the majority of colistin resistance in clinical isolates of E. coli and Klebsiella spp. from the Western Cape of South Africa. Colistin resistance is not clonally disseminated; the mcr-1 gene has been acquired by several unrelated strains of E. coli and K. pneumoniae. Acquisition of mcr-1 by cephalosporin- and carbapenem-resistant Gram negative bacteria may result in untreatable infections and increased mortality. Measures need to be implemented to control the use of colistin in health care facilities and in agriculture to retain its antimicrobial efficacy.
dc.description.urihttps://aricjournal.biomedcentral.com/articles/10.1186/s13756-017-0234-8
dc.format.extent7 pages
dc.language.isoen
dc.publisherBioMed Central
dc.subjectEscherichia colien_ZA
dc.subjectKlebsiella spp.en_ZA
dc.subjectColistin resistanceen_ZA
dc.subjectAntibioticsen_ZA
dc.titlePlasmid-mediated mcr-1 colistin resistance in Escherichia coli and Klebsiella spp. clinical isolates from the Western Cape region of South Africaen_ZA
dc.typeArticle
dc.date.updated2017-08-06T03:33:49Z
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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