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Colistin Resistance in Escherichia coli Isolates From Patients With Bloodstream Infection in Korea

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초록

Dear Editor, Colistin is the last line of defense for carbapenem-resistant Enterobacteriaceae (CRE) or Acinetobacter baumannii infection [1]. Recently, a plasmid-mediated colistin resistance mechanism (mcr-1 gene) was identified in human, animal, and environmental isolates in China, and the worldwide spread of the mcr-1 gene has continuously been reported [2]. This colistin resistance mechanism has mainly been found in isolates linked to community-associated infections or from animals [2]. However, mcr-1-encoding plasmid-mediated colistin-resistant Escherichia coli isolates were detected in a Danish patient with a bloodstream infection [3]. This possibility raises major public health concern for the emerging threats of CRE, given the limited therapeutic options, clinical severity, and poor outcomes. The aim of this study was to evaluate the recent epidemiology of colistin resistance in bloodstream E. coli, including mcr-1-mediated colistin resistance in Korea.

Abstract

Dear Editor, Colistin is the last line of defense for carbapenem-resistant Enterobacteriaceae (CRE) or Acinetobacter baumannii infection [1]. Recently, a plasmid-mediated colistin resistance mechanism (mcr-1 gene) was identified in human, animal, and environmental isolates in China, and the worldwide spread of the mcr-1 gene has continuously been reported [2]. This colistin resistance mechanism has mainly been found in isolates linked to community-associated infections or from animals [2]. However, mcr-1-encoding plasmid-mediated colistin-resistant Escherichia coli isolates were detected in a Danish patient with a bloodstream infection [3]. This possibility raises major public health concern for the emerging threats of CRE, given the limited therapeutic options, clinical severity, and poor outcomes. The aim of this study was to evaluate the recent epidemiology of colistin resistance in bloodstream E. coli, including mcr-1-mediated colistin resistance in Korea.

참고문헌 (6)

  1. Li J, "Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections", Lancet Infect Dis, 6, pp.589~601 (2006)
  2. Liu YY, "Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study", Lancet Infect Dis, 16, pp.161~168 (2016)
  3. Hasman H, "Detection of mcr-1 encoding plasmid-mediated colistin-resistant Escherichia coli isolates from human bloodstream infection and imported chicken meat, Denmark 2015", Euro Surveill, 20(49) (2015)
  4. "Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0" (2016)[URL]
  5. Bialvaei AZ, "Colistin, mechanisms and prevalence of resistance", Curr Med Res Opin, 31, pp.707~721 (2015)
  6. 강철인, "Clinical and Molecular Epidemiology of Community-Onset Bacteremia Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli over a 6-Year Period", Journal of Korean Medical Science, 28(7), pp.998~1004 (2013), 대한의학회

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