title: Prevalence of the mcr-1 colistin resistance gene in extended-spectrum β-lactamase-producing Escherichia coli from human faecal samples collected in 2012 in rural villages in Shandong Province, China.
abstract: Since its initial discovery in China in 2015, the plasmid-mediated colistin resistance gene mcr-1 has been reported in Escherichia coli isolated from clinical samples, animals and meat worldwide. In this study, 706 extended-spectrum β-lactamase (ESBL)-producing E. coli from 411 persons were detected in a collection of faecal samples from 1000 rural residents in three counties in Shandong Province, China. These isolates were screened for mcr-1 and phenotypic colistin resistance. The gene was found in 3.5% of the isolates (from 4.9% of persons) from all three counties. All isolates with phenotypic colistin resistance carried mcr-1. These data indicate that commensal carriage of ESBL-producing E. coli with mcr-1 among persons in rural China was already present in 2012 and that mcr-1 was the most important colistin resistance mechanism. Interventions are necessary to minimise further dissemination of mcr-1, which would limit the future usefulness of colistin as a last-resort antibiotic.
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.
authors.forename: Zhenwang
authors.initials: Z
authors.lastname: Bi
authors.affiliation: Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Berglund
authors.affiliation: Center for Health Management and Policy, Shandong University, Jinan, Shandong, China; Key Lab of Health Economics and Policy Research of Ministry of Health, Shandong University, Jinan, Shandong, China. Electronic address: qiangs@sdu.edu.cn.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Maud
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.
authors.forename: Baoli
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Tärnberg
authors.affiliation: Center for Health Management and Policy, Shandong University, Jinan, Shandong, China; Key Lab of Health Economics and Policy Research of Ministry of Health, Shandong University, Jinan, Shandong, China.
authors.forename: Lilu
authors.initials: L
authors.lastname: Ding
authors.affiliation: Global Health-Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Stålsby Lundborg
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.
authors.forename: Zhenqiang
authors.initials: Z
authors.lastname: Bi
authors.affiliation: Global Health-Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Tomson
authors.affiliation: Center for Health Management and Policy, Shandong University, Jinan, Shandong, China; Key Lab of Health Economics and Policy Research of Ministry of Health, Shandong University, Jinan, Shandong, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Yao
authors.affiliation: Center for Health Management and Policy, Shandong University, Jinan, Shandong, China; Key Lab of Health Economics and Policy Research of Ministry of Health, Shandong University, Jinan, Shandong, China.
authors.forename: Zhanying
authors.initials: Z
authors.lastname: Gu
authors.affiliation: Jinan Central Hospital, Jinan, Shandong, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Yin
authors.affiliation: Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.
authors.forename: Zengqiang
authors.initials: Z
authors.lastname: Kou
authors.affiliation: Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Lennart E
authors.initials: LE
authors.lastname: Nilsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; C000614037:MCR-1 protein, E coli; D001618:beta-Lactamases; D003091:Colistin
keywords: Bacteria; Colistin; Drug resistance; Escherichia coli; Rural China