Transmission of mcr-1-Producing Multidrug-resistant Enterobacteriaceae in Public Transportation in Guangzhou, China

Clin Infect Dis. 2018 Nov 13;67(suppl_2):S217-S224. doi: 10.1093/cid/ciy661.

Abstract

Objectives: mcr-1-mediated colistin resistance in bacteria is concerning, as colistin is used in treating multidrug-resistant bacterial infections. And mcr-1-producing bacteria have been identified in multiple sources. Up to 248 million people use public transportation daily in China, however; public transportation hasn't been studied as a potential source of community-based transmission of mcr-1. Herein we investigated mcr-1-producing isolates from public transportation and explored the genomic characteristics of them.

Methods: Surface samples were collected from public transportation in Guangzhou, China, from October 2016 to April 2017. Polymerase chain reaction was performed to detect mcr-1 gene, plasmid replicon type and phylogenetic group. Minimum inhibitory concentrations (MICs) were determined by microdilution method. S1-nuclease digestion and pulsed-field gel electrophoresis (S1-PFGE) and Southern blotting were performed with mcr-1-harboring plasmids. Whole-genome sequencing was performed with mcr-1-producing isolates.

Results: Of the 737 samples with bacterial growth, 26 isolates were positive for mcr-1, including 23 Escherichia coli and 3 Klebsiella pneumoniae isolates. The E. coli isolates belonged to phylogroups A and B1. Most mcr-1-producing isolates were resistant to ampicillin (25), cefotaxime (21), fosfomycin (16), and gentamicin (15). S1-PFGE, Southern blotting and replicon typing showed that mcr-1 was mainly located on ~33.3 kb to ~220 kb IncX4, IncI2 and IncHI2 plasmids in E. coli, while located on ~33.3 kb untyped plasmid in K. pneumoniae. Several sequence types (ST), including ST2253, ST101, ST10 complex and ST37, were revealed. Between 53 and 66 (mean = 61.8) resistance genes were identified among mcr-1-producing isolates.

Conclusions: Public transportation may serve as a source of mcr-1-producing bacteria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • China / epidemiology
  • Colistin / pharmacology
  • Drug Resistance, Multiple, Bacterial / genetics
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / transmission*
  • Escherichia coli / drug effects
  • Escherichia coli / genetics
  • Escherichia coli Proteins / genetics
  • Humans
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Microbial Sensitivity Tests
  • Motor Vehicles
  • Plasmids / genetics
  • Polymerase Chain Reaction
  • Public Health
  • Railroads
  • Transportation*
  • Whole Genome Sequencing

Substances

  • Anti-Bacterial Agents
  • Escherichia coli Proteins
  • MCR-1 protein, E coli
  • Colistin