title: Plasmid-mediated colistin resistance in Escherichia coli from the Arabian Peninsula.
abstract: OBJECTIVE
  Searching for the presence of the mcr-1 gene in colistin resistant Enterobacteriaceae in countries of the Arabian Peninsula.
  
  
  METHODS
  Seventy-five independent, colistin resistant Enterobacteriaceae strains isolated from clinical cases in Bahrain, Kuwait, Oman, Saudi Arabia and the United Arab Emirates were tested by PCR for the mcr-1 gene. mcr-1 positive strains were genotyped, and their antibiotic susceptibility was established. The mcr-1 containing plasmids were mobilized into Escherichia coli K-12 and their sequence was determined.
  
  
  RESULTS
  Four E. coli isolates (two from Bahrain, one from Saudi Arabia and one from the United Arab Emirates) were identified carrying the mcr-1 gene on conjugative plasmids. They belonged to global multidrug resistant E. coli clones, i.e. ST648, ST224, ST68 and ST131, respectively. One strain carried the blaNDM-1 carbapenemase gene. Three strains carried mcr-1 on IncI2 type plasmids, one of them also harboring a blaCTX-M-64 gene. In the fourth strain mcr-1 was located on a 240kb IncHI2 plasmid co-harboring 13 other resistance genes.
  
  
  CONCLUSIONS
  This is the first report on the presence of the plasmid-coded mcr-1 gene in a variety of multi-resistant clinical isolates from the Arabian Peninsula indicating that several commonly used antibiotics can potentially facilitate the spread of mcr-1 carrying strains, or directly, mcr-1 containing plasmids.
authors: Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
authors: Ágnes
authors: Á
authors: Sonnevend
authors: Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
authors: Akela
authors: A
authors: Ghazawi
authors: Department of Microbiology, BDF Hospital - Royal Medical Services, Riffa, Kingdom of Bahrain.
authors: Manaf
authors: M
authors: Alqahtani
authors: Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
authors: Atef
authors: A
authors: Shibl
authors: Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
authors: Wafa
authors: W
authors: Jamal
authors: Department of Medicine, Tawam Hospital, Al Ain, United Arab Emirates.
authors: Rayhan
authors: R
authors: Hashmey
authors: Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. Electronic address: tpal@uaeu.ac.ae.
authors: Tibor
authors: T
authors: Pal
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007730:Kuwait; D009850:Oman; D010957:Plasmids / Q000235:genetics* / Q000378:metabolism; D012529:Saudi Arabia; D014479:United Arab Emirates; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases; D003091:Colistin
keywords: Escherichia coli; Middle-East; colistin resistance; mcr-1; multi-drug resistance