Colistin-resistance genes in Escherichia coli isolated from patients with urinary tract infections

PLoS One. 2024 Jun 12;19(6):e0305431. doi: 10.1371/journal.pone.0305431. eCollection 2024.

Abstract

Background: The incidence of antimicrobial resistance is alarmingly high because it occurs in humans, environment, and animal sectors from a "One Health" viewpoint. The emergence of plasmid-carried mobile colistin-resistance (MCR) genes limits the efficacy of colistin, which is the last-line treatment for multidrug resistance (MDR) against gram-negative infections.

Objectives: The current study aimed to investigate emergence of colistin-resistance (MCR 1-5) genes in E. coli isolated from patients with urinary tract infections (UTIs) in Jordan.

Methods: E. coli (n = 132) were collected from urine specimens. The E. coli isolated from human UTI patients were examined the resistance to colistin based on the presence of MCR (1-5). All isolates were tested against 20 antimicrobials using the standard disk diffusion method. The broth microdilution technique was used to analyze colistin resistance. In addition, the MCR (1-5) genes were detected using multiplex PCR.

Results: Out of the 132 isolates, 1 isolate was colistin-resistant, having a minimum inhibitory concentration of 8 μg/mL and possessing MCR-1. All the E. coli isolates showed high resistance to penicillin (100%), amoxicillin (79.55%), cephalexin (75.76%), nalidixic acid (62.88%), tetracycline (58.33%), or cefepime (53.79).

Conclusion: To our knowledge, this is the first report on the presence of plasmid-coded MCR-1 in E. coli from a patient with UTIs in Jordan. This is a problematic finding because colistin is the last-line drug for the treatment of infections caused by MDR gram-negative bacteria. There is a crucial need to robustly utilize antibiotics to control and prevent the emergence and prevalence of colistin-resistance genes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Child
  • Colistin* / pharmacology
  • Drug Resistance, Bacterial / genetics
  • Drug Resistance, Multiple, Bacterial / genetics
  • Escherichia coli Infections* / drug therapy
  • Escherichia coli Infections* / microbiology
  • Escherichia coli Proteins / genetics
  • Escherichia coli* / drug effects
  • Escherichia coli* / genetics
  • Escherichia coli* / isolation & purification
  • Female
  • Humans
  • Jordan
  • Male
  • Microbial Sensitivity Tests*
  • Middle Aged
  • Plasmids / genetics
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / microbiology
  • Young Adult

Substances

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

Grants and funding

The author(s) received no specific funding for this work.