MCR-1 and OXA-48 In Vivo Acquisition in KPC-Producing Escherichia coli after Colistin Treatment

Antimicrob Agents Chemother. 2017 Jul 25;61(8):e02540-16. doi: 10.1128/AAC.02540-16. Print 2017 Aug.

Abstract

The spread of mcr-1-encoding plasmids into carbapenem-resistant Enterobacteriaceae raises concerns about the emergence of untreatable bacteria. We report the acquisition of mcr-1 in a carbapenem-resistant Escherichia coli strain after a 3-week course of colistin in a patient repatriated to France from Portugal. Whole-genome sequencing revealed that the Klebsiella pneumoniae carbapenemase-producing E. coli strain acquired two plasmids, an IncL OXA-48-encoding plasmid and an IncX4 mcr-1-encoding plasmid. This is the first report of mcr-1 in carbapenemase-encoding bacteria in France.

Keywords: Escherichia coli; KPC-28; KPC-3; OXA-48; antibiotic resistance; carbapenemase; colistin; mcr-1; β-lactamases.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / metabolism
  • Carbapenem-Resistant Enterobacteriaceae / genetics
  • Colistin / therapeutic use*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Escherichia coli / drug effects*
  • Escherichia coli / genetics*
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / microbiology
  • Escherichia coli Proteins / genetics*
  • France
  • Genome, Bacterial / genetics
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Male
  • Plasmids / genetics
  • Portugal
  • beta-Lactamases / genetics*
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Escherichia coli Proteins
  • MCR-1 protein, E coli
  • beta-Lactamases
  • beta-lactamase KPC-3, Klebsiella pneumoniae
  • beta-lactamase OXA-48, E coli
  • carbapenemase
  • Colistin