| Title |
Multicenter prospective study on the prevalence of colistin resistance in Escherichia coli: relevance of mcr-1-positive clinical isolates in Lombardy, Northern Italy
|
|---|---|
| Published in |
Infection and Drug Resistance, March 2018
|
| DOI | 10.2147/idr.s160489 |
| Pubmed ID | |
| Authors |
Luigi Principe, Aurora Piazza, Carola Mauri, Adriano Anesi, Silvia Bracco, Gioconda Brigante, Erminia Casari, Carlo Agrappi, Mariasofia Caltagirone, Federica Novazzi, Roberta Migliavacca, Laura Pagani, Francesco Luzzaro |
| Abstract |
The emergence of the plasmid-mediated colistin resistance mechanism in Escherichia coli has raised concern among public health experts as colistin is a last-line antimicrobial resort. The primary aim of the study was to investigate the prevalence of this resistance trait in E. coli isolates circulating in the Lombardy region, Northern Italy. The presence of mcr-type genes and their genetic relationship were also studied. A prospective study was performed during a 4-month period (May to August, 2016) in six acute care Hospitals. Consecutive nonduplicate clinical isolates of E. coli from any type of clinical specimen, with the exception of rectal swabs, were included in the study. Isolates that exhibited MIC values for colistin >2 mg/L were further investigated. Bacterial identification was obtained by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Amplification of mcr-type genes (-1 to -5 variants) and microarray analysis were accomplished. Repetitive sequence-based PCR (Rep-PCR) and multilocus sequence typing (MLST) analysis were used for genotyping. Overall, 3,902 consecutive E. coli isolates (2,342 from outpatients, 1,560 from inpatients) were evaluated during the study period. Of them, 18/3,902 (0.5%), collected from 4/6 centers, showed resistance to colistin. These isolates were mostly obtained from urine of both outpatients (n=12) and inpatients (n=6). Colistin MIC values ranged from 4 to 8 mg/L. The mcr-1 gene was detected in 10/18 isolates (7 from outpatients, 3 from inpatients). Rep-PCR and MLST analysis revealed the presence of nine different clusters. Further mcr-type genes were not detected. Resistance to colistin in E. coli clinical isolates appears low in our geographic area. With regard to mcr-1-positive isolates, they accounted for approximately 50% of colistin-resistant E. coli isolates, thus representing a relevant resistance mechanism in this context. Although overall limited, the presence of mcr-1 determinant in our region should not be ignored and great concern should be given to the continuous surveillance. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Scientists | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 52 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 23% |
| Student > Master | 7 | 13% |
| Student > Ph. D. Student | 6 | 12% |
| Student > Bachelor | 4 | 8% |
| Professor > Associate Professor | 2 | 4% |
| Other | 4 | 8% |
| Unknown | 17 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Immunology and Microbiology | 12 | 23% |
| Medicine and Dentistry | 7 | 13% |
| Biochemistry, Genetics and Molecular Biology | 2 | 4% |
| Engineering | 2 | 4% |
| Nursing and Health Professions | 2 | 4% |
| Other | 3 | 6% |
| Unknown | 24 | 46% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 March 2018.
All research outputs
#13,582,950
of 23,026,672 outputs
Outputs from Infection and Drug Resistance
#426
of 1,686 outputs
Outputs of similar age
#171,926
of 331,156 outputs
Outputs of similar age from Infection and Drug Resistance
#13
of 35 outputs
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We're also able to compare this research output to 35 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.