ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
High Rates of Human Fecal Carriage of mcr-1-Positive Multidrug-Resistant Enterobacteriaceae Emerge in China in Association With Successful Plasmid Families.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed, 71 citations in OpenAlex.
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- One Health at Risk: Plasmid-Mediated Spread ofAntibiotics (Basel, Switzerland) · 2025Review
- Detection ofHeliyon · 2024Article
- Global Variation inAntibiotics (Basel, Switzerland) · 2024Article
- Genomic analysis of carbapenem- and colistin-resistant Klebsiella pneumoniae complex harbouring mcr-8 and mcr-9 from individuals in Thailand.Scientific reports · 2024Article
- Inter-plasmid transfer of antibiotic resistance genes accelerates antibiotic resistance in bacterial pathogens.The ISME journal · 2024Article
- Evaluation of the resistome and gut microbiome composition of hospitalized patients in a health unit of southern Brazil coming from a high animal husbandry production region.Frontiers in antibiotics · 2024Article
- Genetic landscape of ESBL producing international clone ST410 ofFrontiers in cellular and infection microbiology · 2024Article
- Carriage and within-host diversity ofEmerging microbes & infections · 2023Article
- Situation Report on mcr-Carrying Colistin-Resistant Clones of Enterobacterales: A Global Update Through Human-Animal-Environment Interfaces.Current microbiology · 2023Review
- Investigating Possible Interspecies Communication of Plasmids Associated with Transfer of Third-Generation Cephalosporin, Quinolone, and Colistin Resistance Between Simultaneously Isolated Escherichia Coli and Klebsiella Pneumoniae.Microbiology spectrum · 2023Article
- Carriage and Transmission ofMicrobiology spectrum · 2023Article
- Worldwide Prevalence ofPathogens (Basel, Switzerland) · 2022Review
- High Carriage of Extended-Spectrum, Beta Lactamase-Producing, and Colistin-Resistant Enterobacteriaceae in Tibetan Outpatients with Diarrhea.Antibiotics (Basel, Switzerland) · 2022Article
- Re-sensitization ofProceedings of the National Academy of Sciences of the United States of America · 2022Article
- Antimicrobial resistance surveillance ofFrontiers in microbiology · 2022Article
- Intestinal colonization with ESBL-producingFrontiers in public health · 2022Article
- Rapid Detection of Multi-Resistance Strains CarryingFrontiers in microbiology · 2022Article
- Clinical Impact of Colistin Banning in Food Animal onFrontiers in microbiology · 2022Article
- Assessing Colistin Resistance by Phenotypic and Molecular Methods in Carbapenem-resistant Enterobacterales in a Tertiary Care Hospital in Pakistan.Infection and drug resistance · 2022Article
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Authors and funding
19 authors at 6 institutions in 3 countries.
Funding
Abstract
Background: mcr-1-mediated colistin resistance in Enterobacteriaceae is concerning, as colistin is used in treating multidrug-resistant Enterobacteriaceae infections. We identified trends in human fecal mcr-1-positivity rates and colonization with mcr-1-positive, third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae in Guangzhou, China, and investigated the genetic contexts of mcr-1 in mcr-1-positive 3GC-R strains. Methods: Fecal samples were collected from in-/out-patients submitting specimens to 3 hospitals (2011-2016). mcr-1 carriage trends were assessed using iterative sequential regression. A subset of mcr-1-positive isolates was sequenced (whole-genome sequencing [WGS], Illumina), and genetic contexts (flanking regions, plasmids) of mcr-1 were characterized. Results: Of 8022 fecal samples collected, 497 (6.2%) were mcr-1 positive, and 182 (2.3%) harbored mcr-1-positive 3GC-R Enterobacteriaceae. We observed marked increases in mcr-1 (0% [April 2011] to 31% [March 2016]) and more recent (since January 2014; 0% [April 2011] to 15% [March 2016]) increases in human colonization with mcr-1-positive 3GC-R Enterobacteriaceae (P < .001). mcr-1-positive 3GC-R isolates were commonly multidrug resistant. WGS of mcr-1-positive 3GC-R isolates (70 Escherichia coli, 3 Klebsiella pneumoniae) demonstrated bacterial strain diversity; mcr-1 in association with common plasmid backbones (IncI, IncHI2/HI2A, IncX4) and sometimes in multiple plasmids; frequent mcr-1 chromosomal integration; and high mobility of the mcr-1-associated insertion sequence ISApl1. Sequence data were consistent with plasmid spread among animal/human reservoirs. Conclusions: The high prevalence of mcr-1 in multidrug-resistant E. coli colonizing humans is a clinical threat; diverse genetic mechanisms (strains/plasmids/insertion sequences) have contributed to the dissemination of mcr-1, and will facilitate its persistence.
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