Emergence of mcr-1 mediated colistin resistant Escherichia coli from a hospitalized patient in Bangladesh

  • Refath Farzana School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
  • Lim S Jones Public Health Wales Microbiology, University Hospital of Wales, Cardiff, United Kingdom
  • Md. Anisur Rahman Department of Virology, Dhaka Medical College, Dhaka, Bangladesh
  • Mark A Toleman School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
  • Kirsty Sands School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
  • Edward Portal School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
  • Ian Boostrom School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
  • Md. Abul Kalam Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
  • Brekhna Hassan School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
  • AKM Nasir Uddin Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Timothy R Walsh School of Medicine, Department of Medical Microbiology, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
Keywords: mcr-1, Human, Bangladesh

Abstract

Introduction: The emergence of plasmid mediated mcr in bacteria has become global public health threat. Herein, we report a mcr-1 positive E. coli in normal human flora from a patient admitted in Dhaka Medical College Hospital (DMCH).

Methodology: In total, 700 non-duplicate rectal swabs were collected from DMCH during 13th May to 12th June 2018. E. coli from rectal swabs were isolated on chromogenic UTI media containing vancomycin 10mg/l (Liofilchem, Italy) and confirmed by MALDI-TOF. Minimum inhibitory concentrations (MIC) were determined by agar dilution and interpreted according to EUCAST breakpoints. Genomic analysis of mcr positive E. coli (MCRPEC) was performed by Illumina MiSeq sequencing and pulsed field gel electrophoresis (PFGE) using S1 nuclease DNA digests and blamcr-1 probing. Transferability of blamcr-1 were determined by conjugation assays.

Results: We found one MCRPEC from 700 rectal swab screening which was isolated from the rectal swab culture of a 17-year boy who was admitted to the burns ICU, DMCH with 53% flame burn involving much of the trunk and face. Genome sequencing revealed that mcr-1 was present on an IncH12 plasmid of 257,243 bp and flanked by ISApaI1. The colistin resistance can be transferred to the recipient Klebsiella varricola with a frequency of 8.3 × 10-5. Transconjugants were more resistant to colistin than donor (MIC 32 µg/mL).

Conclusions: This is the first human associated mcr in Bangladesh. These data indicate the need for a systematic “one health” surveillance in the country.

Published
2019-08-31
How to Cite
1.
Farzana R, Jones LS, Rahman MA, Toleman MA, Sands K, Portal E, Boostrom I, Kalam MA, Hassan B, Uddin AN, Walsh TR (2019) Emergence of mcr-1 mediated colistin resistant Escherichia coli from a hospitalized patient in Bangladesh. J Infect Dev Ctries 13:773-776. doi: 10.3855/jidc.11541
Section
Letters to the Editor