Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
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Sep 13, 2024
About this article
Article Category: ORIGINAL PAPER
Published Online: Sep 13, 2024
Page range: 363 - 375
Received: May 15, 2024
Accepted: Jul 23, 2024
DOI: https://doi.org/10.33073/pjm-2024-032
Keywords
© 2024 Yue Liu et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Antibiotic susceptibility testing of Escherichia coli clinical strains, transconjugants, and the recipient bacterium J53AziR_
| Isolates | MIC (μg/ml) | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMP | SAM | TZP | CZO | CTT | CRO | CAZ | FEP | ATM | ETP | IPM | AK | CN | TOB | CIP | LEV | NIT | STX | POL | |
| ECO-POL-4 | ≥ 32 | ≥ 32 | ≥ 128 | ≥ 64 | ≥ 64 | ≥ 64 | ≥ 64 | ≥ 64 | 16 | ≥ 8 | ≥ 16 | ≤ 2 | ≤ 1 | ≤ 1 | ≥ 4 | ≥ 8 | 32 | ≥ 320 | 8 |
| ECO-POL-6 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | 32 | ≥ 64 | ≤ 1 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | 40 | 4 |
| ECO-POL-7 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | ≤ 16 | ≥ 320 | 4 |
| ECO-POL-8 | ≥ 32 | 8 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | 2 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≥ 4 | ≥ 8 | 32 | ≥ 320 | 4 |
| ECO-POL-9 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 4 | 2 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | 8 | ≥ 4 | ≥ 8 | ≤ 16 | ≥ 320 | 4 |
| ECO-POL-10 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≥ 4 | 4 | 32 | ≥ 320 | 4 |
| ECO-POL-15 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≥ 64 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | ≤ 20 | 8 |
| ECO-POL-17 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≥ 64 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 32 | ≤ 20 | 4 |
| ECO-POL-18 | ≥ 32 | ≥ 32 | 16 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | 32 | ≥ 64 | ≤ 0.5 | ≤ 1 | 16 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | ≤ 16 | ≥ 320 | ≥ 64 |
| ECO-POL-19 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | 32 | 32 | ≤ 0.5 | ≤ 1 | ≥ 64 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | ≥ 320 | 4 |
| ECO-POL-21 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | ≥ 320 | 4 |
| ECO-POL-22 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | ≤ 1 | 2 | 16 | ≤ 0.5 | ≤ 1 | ≥ 64 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | ≥ 320 | 4 |
| ECO-POL-23 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | ≥ 320 | 4 |
| ECO-POL-24 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | 32 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | 8 | ≥ 4 | ≥ 8 | ≤ 16 | ≥ 320 | 4 |
| ECO-POL-25 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 4 | ≥ 64 | 32 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≥ 4 | ≥ 8 | 128 | ≤ 20 | 4 |
| ECO-POL-27 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 4 | 2 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | 8 | ≥ 4 | ≥ 8 | 64 | ≤ 20 | 4 |
| ECO-POL-28 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | ≤ 1 | 2 | 4 | ≤ 0.5 | ≤ 1 | ≥ 64 | ≥ 16 | ≥ 16 | ≥ 4 | ≥ 8 | 64 | ≥ 320 | 4 |
| ECO-POL-29 | ≥ 32 | 8 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 4 | 2 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≥ 4 | ≥ 8 | 32 | ≥ 320 | 4 |
| ECO-POL-30 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | 32 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | 8 | ≥ 4 | ≥ 8 | ≤ 16 | ≥ 320 | 4 |
| J4 | ≥ 32 | ≥ 32 | 64 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 8 |
| J6 | 8 | 8 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J7 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≥ 320 | 4 |
| J8 | 4 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J9 | 4 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 8 |
| J10 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J15 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 4 | 2 | 16 | ≤ 0.5 | ≤ 1 | ≤ 2 | 8I | ≥ 16 | ≤ 0.25 | ≤ 0.25 | 32 | ≤ 20 | 16 |
| J18 | 8 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 8 |
| J19 | 8 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J21 | 8 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J22 | 8 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J23 | 8 | 4 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J24 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | ≥ 64 | 8 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≥ 320 | 8 |
| J25 | ≥ 32 | 16 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | 16 | ≥ 64 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 4 |
| J27 | 8 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 8 |
| J29 | 4 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 8 |
| J30 | ≥ 32 | ≥ 32 | ≤ 4 | ≥ 64 | ≤ 4 | ≥ 64 | ≥ 64 | 8 | ≥ 64 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≥ 16 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≥ 320 | 8 |
| J53AziR | 8 | ≤ 2 | ≤ 4 | ≤ 4 | ≤ 4 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 1 | ≤ 0.5 | ≤ 1 | ≤ 2 | ≤ 1 | ≤ 1 | ≤ 0.25 | ≤ 0.25 | ≤ 16 | ≤ 20 | 0.125 |
The number, approximate size and replicon types of plasmids in 19 strains of mcr-1-positive polymyxin B-resistant Escherichia coli producing extended-spectrum β-lactamase and 17 transconjugants_
| Isolates | Plasmid numbers | Size (kbp) | Replicon types |
|---|---|---|---|
| ECO-POL-4 | 3 | ~ 110, ~ 65, ~ 45 | ColRNAI, IncFIA, IncFIC, IncFIC, IncX3 |
| ECO-POL-6 | 6 | ~ 210, ~ 140, ~ 110, ~ 104.5, ~ 78.2, ~ 65 | Col, ColRNAI, ColpVC, IncFIB, IncFII, IncHI1B, IncHI2A, |
| IncHI2, IncI1, IncI2, RepA, p0111 | |||
| ECO-POL-7 | 5 | ~ 220, ~ 138, ~ 100, ~ 65, ~ 54 | IncFIB, IncFIC, IncFII, IncHI2A, IncHI2, IncI2a, |
| RepA_1_pKPC-CAV1321 | |||
| ECO-POL-8 | 4 | ~ 140, ~ 100, ~ 33, ~ 21 | IncFIB, IncFIC, IncX4 |
| ECO-POL-9 | 3 | ~ 140, ~ 100, < 20 | Col156, Col440II, ColRNAI, IncB/O/K/Z, IncFIA, IncFIB1, |
| IncFIC, IncI2, IncX1, IncY | |||
| ECO-POL-10 | 4 | ~ 140, ~ 65, ~ 34, ~ 30 | Col, Col156, Col8282, IncFIB, IncFII, IncI2, IncX4 |
| ECO-POL-15 | 3 | ~ 265, ~ 65, ~ 45 | Col, IncFII, IncHI2A, IncHI2, IncN, IncX1, RepA |
| ECO-POL-17 | 3 | ~ 104.5, ~ 65, ~ 48 | Col440I, ColRNAI, IncI1, IncI2, IncN, IncR, IncX1 |
| ECO-POL-18 | 3 | ~ 110, ~ 104.5, ~ 65 | IncFIB, IncFIC, IncHI2A, IncHI2, IncI2, RepA |
| ECO-POL-19 | 3 | ~ 265, ~ 140, ~ 48 | Col156, Col440I, IncFIB, IncFIC, IncFII, IncHI2A, IncHI2, RepA |
| ECO-POL-21 | 2 | ~ 140, ~ 65 | Col156, IncFIB, IncFIC, IncI2 |
| ECO-POL-22 | 3 | ~ 180, ~ 110, ~ 65 | Col440II, ColRNAI, IncFIB, IncFIC, IncI2, IncI |
| ECO-POL-23 | 2 | ~ 140, ~ 65 | Col156, IncFIB, IncFIC, IncI2 |
| ECO-POL-24 | 2 | ~ 140, ~ 65 | IncFIB, IncI2 |
| ECO-POL-25 | 3 | ~ 140, ~ 95, ~ 65 | IncB/O/K/Z, IncFIB, IncI2, p0111 |
| ECO-POL-27 | 6 | ~ 140, ~ 130, ~ 95, ~ 70, ~ 65, ~ 43 | Col(MG828), ColE10, ColRNAI, IncB/O/K/Z, IncFIB, IncFIC, |
| IncFII, IncI2, IncX1, p0111 | |||
| ECO-POL-28 | 2 | ~ 90, ~ 28 | Col, Col156, Col440I, ColRNAI, IncFIA, IncFIB, IncI, IncX1 |
| ECO-POL-29 | 4 | 128.293, 83.176, 62.869, 30.619 | IncFIB/IncFIC, IncFIC, IncI2, IncX4 |
| ECO-POL-30 | 2 | ~ 130, ~ 60 | IncFIB, IncI2 |
| J4 | 1 | ~ 65 | IncI2 |
| J6 | 1 | ~ 65 | IncI2 |
| J7 | 4 | ~ 103, ~ 100, ~ 65, ~ 60 | IncI2, IncFIB, IncFII, IncFIC |
| J8 | 2 | ~ 100, ~ 33 | IncFIB, IncX4 |
| J9 | 1 | ~ 65 | IncI2 |
| J10 | 3 | ~ 65, ~ 33, ~ 30 | IncI2, IncX4 |
| J15 | 1 | ~ 255 | IncHI2, RepA, IncHI2A, IncN |
| J18 | 1 | ~ 65 | IncI2 |
| J19 | 1 | ~ 255 | IncHI2A, IncHI2, RepA |
| J21 | 1 | ~ 65 | IncI2 |
| J22 | 1 | ~ 65 | IncI2, ColRNAI |
| J23 | 1 | ~ 65 | IncI2 |
| J24 | 2 | ~ 140, ~ 65 | IncI2, IncFIB |
| J25 | 1 | ~ 65 | IncI2 |
| J27 | 1 | ~ 65 | IncI2 |
| J29 | 2 | ~ 65, ~ 33 | IncI2, IncX4 |
| J30 | 2 | ~ 140, ~ 65 | IncI2, IncFIB |
Clinical data of patients infected with mcr-1 -positive Escherichia coli isolates producing extended-spectrum β-lactamase_
| Clinical isolates | Gender | Department | Specimen | Clinical diagnosis | Antimicrobial therapy |
|---|---|---|---|---|---|
| ECO-POL-4 | male | Intensive Care Unit | urine | aspiration pneumonia, ARDS | cefoperazone sodium/sulbactam sodium |
| ECO-POL-6 | female | Orthopedic Oncology and Joint Surgery Department | urine | recurrence of intradural teratoma | levofloxacin, levofloxacin sodium chloride, ceftazidime |
| ECO-POL-7 | female | Gastroenterology Department | bile | postoperative recurrence of pancreatic cancer | piperacillin/tazobactam |
| ECO-POL-8 | female | Emergency Department | secretion | acute purulent appendicitis | meropenem sodium/sulbactam sodium |
| ECO-POL-9 | female | Urology Department | urine | ureteral stone | – |
| ECO-POL-10 | female | Minimally Invasive Urology Department | urine | left renal abscess | cefotaxime |
| ECO-POL-15 | male | Minimally Invasive Urology Department | urine | post-prostatectomy for prostate cancer | cefotaxime |
| ECO-POL-17 | male | General Surgery Department | puncture fluid | post-pancreaticoduodenectomy | cefoperazone sodium/sulbactam sodium, imipenem/cilastatin |
| ECO-POL-18 | female | Urology Department | urine | bilateral ureteral stones | meropenem |
| ECO-POL-19 | female | Minimally Invasive Urology Department | urine | urinary retention | ceftriaxone sodium |
| ECO-POL-21 | male | Respiratory Department | sputum | severe pneumonia | fluconazole, cefoperazone sodium/sulbactam sodium, carbapenem |
| ECO-POL-22 | male | Intensive Care Unit | drainage fluid | open pelvic fracture with ARDS | imipenem/cilastatin |
| ECO-POL-23 | male | Intensive Care Unit | bronchoalveolar lavage fluid | septic shock | carbapenem, imipenem/cilastatin, daptomycin, meropenem + polymyxin B, vancomycin + fluconazole |
| ECO-POL-24 | male | Trauma and Orthopedics | secretion | traumatic hemorrhagic shock | cefotaxime, clindamycin hydrochloride |
| ECO-POL-25 | female | Spinal Surgery Department | puncture fluid | postoperative infection following lumbar spine surgery | penicillin, cefepime + levofloxacin, imipenem/cilastatin |
| ECO-POL-27 | male | Thoracic Surgery Department | sputum | post-chemotherapy for right upper lobe lung cancer | cefuroxime |
| ECO-POL-28 | male | Intensive Care Unit | pus | gastrointestinal bleeding, gastric ulcer | cefoperazone sodium/sulbactam sodium, linezolid |
| ECO-POL-29 | male | General Surgery Department | ascitic puncture fluid | post-appendectomy for appendiceal cancer, colonic lesion | imipenem/cilastatin |
| ECO-POL-30 | male | Trauma and Orthopedics | secretion | hemorrhagic shock | cefotaxime |