The global distribution and spread of the mobilized colistin resistance gene mcr-1

Nat Commun. 2018 Mar 21;9(1):1179. doi: 10.1038/s41467-018-03205-z.

Abstract

Colistin represents one of the few available drugs for treating infections caused by carbapenem-resistant Enterobacteriaceae. As such, the recent plasmid-mediated spread of the colistin resistance gene mcr-1 poses a significant public health threat, requiring global monitoring and surveillance. Here, we characterize the global distribution of mcr-1 using a data set of 457 mcr-1-positive sequenced isolates. We find mcr-1 in various plasmid types but identify an immediate background common to all mcr-1 sequences. Our analyses establish that all mcr-1 elements in circulation descend from the same initial mobilization of mcr-1 by an ISApl1 transposon in the mid 2000s (2002-2008; 95% highest posterior density), followed by a marked demographic expansion, which led to its current global distribution. Our results provide the first systematic phylogenetic analysis of the origin and spread of mcr-1, and emphasize the importance of understanding the movement of antibiotic resistance genes across multiple levels of genomic organization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Americas / epidemiology
  • Anti-Bacterial Agents / pharmacology
  • Asia / epidemiology
  • Carbapenems / pharmacology
  • Colistin / pharmacology*
  • DNA Transposable Elements*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Enterobacteriaceae / classification
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / genetics*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae Infections / transmission
  • Escherichia coli Proteins / genetics*
  • Escherichia coli Proteins / metabolism
  • Europe / epidemiology
  • Evolution, Molecular
  • Gene Expression
  • Gene Transfer, Horizontal
  • Genome, Bacterial*
  • Humans
  • Plasmids / chemistry
  • Plasmids / metabolism
  • Population Dynamics

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • DNA Transposable Elements
  • Escherichia coli Proteins
  • MCR-1 protein, E coli
  • Colistin