Skip to main content
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems
  • Log in
  • My alerts
  • My Cart

Main menu

  • Home
  • Articles
    • Latest Articles
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • Topics
    • Applied and Environmental Science
    • Clinical Science and Epidemiology
    • Ecological and Evolutionary Science
    • Host-Microbe Biology
    • Molecular Biology and Physiology
    • Therapeutics and Prevention
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About mBio
    • Editor in Chief
    • Board of Editors
    • AAM Fellows
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • RSS
    • FAQ
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems

User menu

  • Log in
  • My alerts
  • My Cart

Search

  • Advanced search
mBio
publisher-logosite-logo

Advanced Search

  • Home
  • Articles
    • Latest Articles
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • Topics
    • Applied and Environmental Science
    • Clinical Science and Epidemiology
    • Ecological and Evolutionary Science
    • Host-Microbe Biology
    • Molecular Biology and Physiology
    • Therapeutics and Prevention
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About mBio
    • Editor in Chief
    • Board of Editors
    • AAM Fellows
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • RSS
    • FAQ
Observation

Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States

José R. Mediavilla, Amee Patrawalla, Liang Chen, Kalyan D. Chavda, Barun Mathema, Christopher Vinnard, Lisa L. Dever, Barry N. Kreiswirth
George A. Jacoby, Editor
José R. Mediavilla
aPublic Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amee Patrawalla
bDivision of Pulmonary and Critical Care Medicine, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Liang Chen
aPublic Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kalyan D. Chavda
aPublic Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Barun Mathema
cDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christopher Vinnard
aPublic Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lisa L. Dever
dDivision of Infectious Diseases, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Barry N. Kreiswirth
aPublic Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
George A. Jacoby
Lahey Hospital and Medical Center
Roles: Editor
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
DOI: 10.1128/mBio.01191-16
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

ABSTRACT

Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized.

IMPORTANCE Colistin has become the last line of defense for the treatment of infections caused by Gram-negative bacteria resistant to multiple classes of antibiotics, in particular carbapenem-resistant Enterobacteriaceae (CRE). Resistance to colistin, encoded by the plasmid-borne gene mcr-1, was first identified in animal and clinical samples from China in November 2015 and has subsequently been reported from numerous other countries. In April 2016, mcr-1 was identified in a carbapenem-susceptible Escherichia coli strain from a clinical sample in the United States, followed by a second report from a carbapenem-susceptible E. coli strain originally isolated in May 2015. We report the isolation and identification of an E. coli strain harboring both colistin (mcr-1) and carbapenem (blaNDM-5) resistance genes, originally isolated in August 2014 from urine of a patient with recurrent urinary tract infections. To our knowledge, this is the first report in the United States of a clinical bacterial isolate with both colistin and carbapenem resistance, highlighting the importance of active surveillance efforts for colistin- and carbapenem-resistant organisms.

Observation

Polymyxins are increasingly used as antibiotics of last resort for clinical infections caused by carbapenem-resistant Gram-negative bacteria, especially carbapenem-resistant Enterobacteriaceae (CRE) (1). The recent discovery of transmissible colistin resistance in China (2) has led to numerous reports of the plasmid-borne gene mcr-1 in animal, food, and clinical samples worldwide (3). Of particular concern is the spread of mcr-1 into CRE, thereby creating highly drug-resistant strains that are potentially untreatable. Several reports outside the United States have already described mcr-1 in bacterial strains harboring carbapenemases, including NDM-1 (4), NDM-5 (5–7), NDM-9 (8), KPC-2 (9), OXA-48 (10), and VIM-1 (11). Most recently, mcr-1 was detected in two clinical carbapenem-susceptible Escherichia coli strains from the United States, isolated from urine cultures obtained in April 2016 (12) and May 2015 (13), respectively. Here, we report the identification from urine of an E. coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5, originally isolated in August 2014 from a U.S. patient with recurrent urinary tract infections and no recent travel history.

A 76-year-old man presented to a tertiary-care hospital in New Jersey with subjective fever and flank pain in August 2014. The patient had emigrated from India and resided continuously in the United States for 1 year prior to this presentation. He had a history of prostate cancer treated with radiation therapy and subsequently developed recurrent urinary tract infections. He had recently undergone cystoscopy to evaluate the possibility of colovesicular fistula formation. The procedure was complicated by bladder perforation requiring bilateral nephrostomy tube placement. The nephrostomy tubes were clamped 5 days prior to presentation, and he then developed subjective fever, chills, and generalized weakness. Laboratory testing on presentation indicated a leukocyte count of 14.1 × 103 cells/µl, associated with pyuria. The initial antimicrobial regimen included intravenous piperacillin-tazobactam and vancomycin. No fistula was seen on imaging studies, and the nephrostomy tubes were unclamped.

The susceptibility results of urine cultures obtained prior to the initiation of antimicrobial therapy are shown in Table 1. A clean-catch urine culture grew greater than 100,000 CFU per ml of Pseudomonas aeruginosa, Citrobacter koseri, and Enterococcus faecium. A urine culture obtained from the nephrostomy tube grew >100,000 CFU/ml of P. aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterococcus spp., and Staphylococcus aureus (methicillin resistant). Susceptibility testing results showed that the E. coli isolate was resistant to colistin and all β-lactams (including carbapenems) except aztreonam, but remained susceptible to amikacin, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole (Table 1). The P. aeruginosa isolate was susceptible to piperacillin-tazobactam and colistin but exhibited resistance or intermediate resistance to other agents tested, including carbapenems. In contrast, the C. koseri and K. pneumoniae isolates were resistant to only ampicillin, with the latter also exhibiting intermediate resistance to nitrofurantoin. Based on these culture results, oral trimethoprim-sulfamethoxazole was added to the antimicrobial regimen, although by this point the patient had remained afebrile and the leukocyte count had normalized. A sterile clean-catch urine culture was obtained after 6 days of antimicrobial therapy. The patient returned home after undergoing a urinary diversion with ileal conduit.

View this table:
  • View inline
  • View popup
TABLE 1 

Antimicrobial susceptibilities of Gram-negative bacterial species isolated from urine cultures and nephrostomy tube drainage obtained from the case patiente

Since 2014, our laboratory has used molecular methods to analyze clinical isolates of Gram-negative bacteria obtained from this affiliated tertiary-care hospital, including 16S sequencing; multilocus sequence typing (MLST); and PCR detection of carbapenemases, AmpC β-lactamases, extended-spectrum β-lactamase genes, and, more recently, the mcr-1 gene. Using these methods, the E. coli isolate from the study case (named MCR1_NJ) was shown to carry both mcr-1 and blaNDM-5 genes. Whole-genome sequencing of E. coli strain MCR1_NJ was performed using an Illumina NextSeq platform (San Diego, CA), and the resistome was investigated using ResFinder 2.1 (14). In addition to mcr-1 and blaNDM-5, strain MCR1_NJ was found to harbor resistance genes for aminoglycosides [strA, strB, and aac(6′)-Ib-cr], β-lactams (blaOXA-1), chloramphenicol (catB3 and floR), fluoroquinolones [aac(6′)-Ib-cr], rifampin (arr-3), sulfonamides (sul1 and sul2), and tetracycline [tet(A)].

The mcr-1- and blaNDM-5-harboring plasmids from E. coli strain MCR1_NJ were transferred to E. coli DH10B by electroporation, thereby confirming the mutually exclusive presence of mcr-1 and blaNDM-5 in the resulting transformants. The conjugability of the mcr-1 plasmid was further confirmed by experiments using E. coli J53 Azir as the recipient strain. Plasmid DNA was isolated using a Qiagen Plasmid Midi kit (Hilden, Germany) and subjected to complete plasmid sequencing using Illumina NextSeq as described previously (6). Sequencing reads were assembled de novo using SPAdes software (15), and gaps were closed by Sanger sequencing as described previously (6, 16). The mcr-1-harboring plasmid from E. coli MCR1_NJ (subsequently named pMCR1-NJ-IncX4) was 33,395 bp in length and had 100% BLAST query coverage and 99.6% nucleotide identity to conjugative plasmid pMCR1-IncX4 (GenBank accession no. KU761327), which we previously described in CTX-M-55-producing E. coli and NDM-5-producing K. pneumoniae strains from Chinese hospitals (5, 6). The blaNDM-5-harboring plasmid (named pNDM5-NJ-IncX3) was 39,520 bp in length and closely related (100% nucleotide identity and 79% query coverage) to pNDM5-IncX3 (accession no. KU761328), previously described in the two aforementioned NDM-5-producing K. pneumoniae strains from China (6). No other resistance genes besides mcr-1 and blaNDM-5 were observed in plasmid pMCR1-NJ-IncX4 or pNDM5-NJ-IncX3, respectively.

Strain MCR1_NJ was shown by MLST to be a single-locus variant of ST405, associated with E. coli phylogroup D (17). ST405 is classified as one of the main extraintestinal pathogenic E. coli (ExPEC) lineages (18), and is associated with the global spread of extended-spectrum β-lactamases, most notably CTX-M-15 (18–20). AmpC cephamycinases and NDM metallo-β-lactamases have also been reported in ST405 (20), including NDM-1 (21) and NDM-4 (22). Consequently, ST405 may also be involved in the global dissemination of NDM-producing E. coli strains (22). Moreover, whereas strain MCR1_NJ was susceptible to various antibiotics, including gentamicin and trimethoprim-sulfamethoxazole, studies of ST405 strains from multiple countries suggest that they are typically resistant to these as well (20). Worrisomely, ST405 has been frequently associated with community onset urinary tract infections (23–25). Dissemination of mcr-1 within this global lineage may therefore contribute to further spread of polymyxin resistance within ESBL- and carbapenemase-producing E. coli (and other Enterobacteriaceae) strains.

In summary, we report the isolation and identification of an E. coli strain harboring both mcr-1 and blaNDM-5 from urine of a patient without recent travel outside the United States. This strain was isolated in August 2014, highlighting an earlier presence of mcr-1 within the region than previously known and raising the likelihood of ongoing undetected transmission. Active surveillance efforts involving all polymyxin- and carbapenem-resistant organisms are imperative in order to determine mcr-1 prevalence and prevent further dissemination.

Accession number(s).The complete nucleotide sequences of plasmids pMCR1-NJ-IncX4 and pNDM5-NJ-IncX3 have been deposited as GenBank accession no. KX447768 and KX447767, respectively. The draft genome sequence of E. coli strain MCR1_NJ was deposited as GenBank accession no. MAJK00000000.

ACKNOWLEDGMENTS

This study was supported by grants from the National Institutes of Health (grants R01AI090155 to B.N.K. and R21AI117338 to L.C.).

B.N.K. discloses that he holds two patents that focus on using DNA sequencing to identify bacterial pathogens.

FOOTNOTES

    • Received 1 July 2016
    • Accepted 3 August 2016
    • Published 30 August 2016
  • Copyright © 2016 Mediavilla et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

REFERENCES

  1. 1.↵
    1. Kaye KS,
    2. Pogue JM,
    3. Tran TB,
    4. Nation RL,
    5. Li J
    . 2016. Agents of last resort: polymyxin resistance. Infect Dis Clin North Am 30:391–414. doi:10.1016/j.idc.2016.02.005.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Liu YY,
    2. Wang Y,
    3. Walsh TR,
    4. Yi LX,
    5. Zhang R,
    6. Spencer J,
    7. Doi Y,
    8. Tian G,
    9. Dong B,
    10. Huang X,
    11. Yu LF,
    12. Gu D,
    13. Ren H,
    14. Chen X,
    15. Lv L,
    16. He D,
    17. Zhou H,
    18. Liang Z,
    19. Liu JH,
    20. Shen J
    . 2016. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis 16:161–168. doi:10.1016/S1473-3099(15)00424-7.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Schwarz S,
    2. Johnson AP
    . 2016. Transferable resistance to colistin: a new but old threat. J Antimicrob Chemother 71:2066–2070. doi:10.1093/jac/dkw274.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Delgado-Blas JF,
    2. Ovejero CM,
    3. Abadia Patino L,
    4. Gonzalez-Zorn B
    . 18 July 2016. Coexistence of mcr-1 and blaNDM-1 in Escherichia coli from Venezuela. Antimicrob Agents Chemother doi:10.1128/AAC.01319-16. Epub ahead of print.
    OpenUrlCrossRef
  5. 5.↵
    1. Yu H,
    2. Qu F,
    3. Shan B,
    4. Huang B,
    5. Jia W,
    6. Chen C,
    7. Li A,
    8. Miao M,
    9. Zhang X,
    10. Bao C,
    11. Xu Y,
    12. Chavda KD,
    13. Tang YW,
    14. Kreiswirth BN,
    15. Du H,
    16. Chen L
    . 2016. Detection of the mcr-1 colistin resistance gene in carbapenem-resistant Enterobacteriaceae from different hospitals in China. Antimicrob Agents Chemother 60:5033–5035. doi:10.1128/AAC.00440-16.
    OpenUrlAbstract/FREE Full Text
  6. 6.↵
    1. Li A,
    2. Yang Y,
    3. Miao M,
    4. Chavda KD,
    5. Mediavilla JR,
    6. Xie X,
    7. Feng P,
    8. Tang YW,
    9. Kreiswirth BN,
    10. Chen L,
    11. Du H
    . 2016. Complete sequences of mcr-1-harboring plasmids from extended-spectrum-β-lactamase- and carbapenemase-producing Enterobacteriaceae. Antimicrob Agents Chemother 60:4351–4354. doi:10.1128/AAC.00550-16.
    OpenUrlAbstract/FREE Full Text
  7. 7.↵
    1. Du H,
    2. Chen L,
    3. Tang Y,
    4. Kreiswirth BN
    . 2016. Emergence of the mcr-1 colistin resistance gene in carbapenem-resistant Enterobacteriaceae. Lancet Infect Dis 16:287–288. doi:10.1016/S1473-3099(16)00056-6.
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Yao X,
    2. Doi Y,
    3. Zeng L,
    4. Lv L,
    5. Liu J
    . 2016. Carbapenem-resistant and colistin-resistant Escherichia coli co-producing NDM-9 and MCR-1. Lancet Infect Dis 16:288–289. doi:10.1016/S1473-3099(16)00057-8.
    OpenUrlCrossRefPubMed
  9. 9.↵
    1. Falgenhauer L,
    2. Waezsada SE,
    3. Yao Y,
    4. Imirzalioglu C,
    5. Kasbohrer A,
    6. Roesler U,
    7. Michael GB,
    8. Schwarz S,
    9. Werner G,
    10. Kreienbrock L,
    11. Chakraborty T
    . 2016. Colistin resistance gene mcr-1 in extended-spectrum β-lactamase-producing and carbapenemase-producing Gram-negative bacteria in Germany. Lancet Infect Dis 16:282–283. doi:10.1016/S1473-3099(16)00009-8.
    OpenUrlCrossRefPubMed
  10. 10.↵
    1. Mulvey MR,
    2. Mataseje LF,
    3. Robertson J,
    4. Nash JHE,
    5. Boerlin P,
    6. Toye B,
    7. Irwin R,
    8. Melano RG
    . 2016. Dissemination of the mcr-1 colistin resistance gene. Lancet Infect Dis 16:289–290. doi:10.1016/S1473-3099(16)00067-0.
    OpenUrlCrossRefPubMed
  11. 11.↵
    1. Poirel L,
    2. Kieffer N,
    3. Liassine N,
    4. Thanh D,
    5. Nordmann P
    . 2016. Plasmid-mediated carbapenem and colistin resistance in a clinical isolate of Escherichia coli. Lancet Infect Dis 16:281. doi:10.1016/S1473-3099(16)00006-2.
    OpenUrlCrossRef
  12. 12.↵
    1. McGann P,
    2. Snesrud E,
    3. Maybank R,
    4. Corey B,
    5. Ong AC,
    6. Clifford R,
    7. Hinkle M,
    8. Whitman T,
    9. Lesho E,
    10. Schaecher KE
    . 2016. Escherichia coli harboring mcr-1 and blaCTX-M on a novel IncF plasmid: first report of mcr-1 in the United States. Antimicrob Agents Chemother 60:4420–4421. doi:10.1128/AAC.01103-16.
    OpenUrlFREE Full Text
  13. 13.↵
    1. Castanheira M,
    2. Griffin MA,
    3. Deshpande LM,
    4. Mendes RE,
    5. Jones RN,
    6. Flamm RK
    . 11 July 2016. Detection of mcr-1 among Escherichia coli clinical isolates collected worldwide as part of the SENTRY Antimicrobial Surveillance Program during 2014–2015. Antimicrob Agents Chemother doi:10.1128/AAC.01267-16. Epub ahead of print.
    OpenUrlFREE Full Text
  14. 14.↵
    1. Zankari E,
    2. Hasman H,
    3. Cosentino S,
    4. Vestergaard M,
    5. Rasmussen S,
    6. Lund O,
    7. Aarestrup FM,
    8. Larsen MV
    . 2012. Identification of acquired antimicrobial resistance genes. J Antimicrob Chemother 67:2640–2644. doi:10.1093/jac/dks261.
    OpenUrlCrossRefPubMedWeb of Science
  15. 15.↵
    1. Bankevich A,
    2. Nurk S,
    3. Antipov D,
    4. Gurevich AA,
    5. Dvorkin M,
    6. Kulikov AS,
    7. Lesin VM,
    8. Nikolenko SI,
    9. Pham S,
    10. Prjibelski AD,
    11. Pyshkin AV,
    12. Sirotkin AV,
    13. Vyahhi N,
    14. Tesler G,
    15. Alekseyev MA,
    16. Pevzner PA
    . 2012. SPAdes: a new genome assembly algorithm and its applications to single-cell sequencing. J Comput Biol 19:455–477. doi:10.1089/cmb.2012.0021.
    OpenUrlCrossRefPubMed
  16. 16.↵
    1. Chen L,
    2. Hu H,
    3. Chavda KD,
    4. Zhao S,
    5. Liu R,
    6. Liang H,
    7. Zhang W,
    8. Wang X,
    9. Jacobs MR,
    10. Bonomo RA,
    11. Kreiswirth BN
    . 2014. Complete sequence of a KPC-producing IncN multidrug-resistant plasmid from an epidemic Escherichia coli sequence type 131 strain in China. Antimicrob Agents Chemother 58:2422–2425. doi:10.1128/AAC.02587-13.
    OpenUrlAbstract/FREE Full Text
  17. 17.↵
    1. Sousa C,
    2. Novais Â,
    3. Magalhães A,
    4. Lopes J,
    5. Peixe L
    . 2013. Diverse high-risk B2 and D Escherichia coli clones depicted by Fourier transform infrared spectroscopy. Sci Rep 3:3278. doi:10.1038/srep03278.
    OpenUrlCrossRef
  18. 18.↵
    1. Naseer U,
    2. Sundsfjord A
    . 2011. The CTX-M conundrum: dissemination of plasmids and Escherichia coli clones. Microb Drug Resist 17:83–97. doi:10.1089/mdr.2010.0132.
    OpenUrlCrossRefPubMedWeb of Science
  19. 19.↵
    1. Coque TM,
    2. Novais A,
    3. Carattoli A,
    4. Poirel L,
    5. Pitout J,
    6. Peixe L,
    7. Baquero F,
    8. Cantón R,
    9. Nordmann P
    . 2008. Dissemination of clonally related Escherichia coli strains expressing extended-spectrum β-lactamase CTX-M-15. Emerg Infect Dis 14:195–200. doi:10.3201/eid1402.070350.
    OpenUrlCrossRefPubMedWeb of Science
  20. 20.↵
    1. Novais Â,
    2. Vuotto C,
    3. Pires J,
    4. Montenegro C,
    5. Donelli G,
    6. Coque TM,
    7. Peixe L
    . 2013. Diversity and biofilm-production ability among isolates of Escherichia coli phylogroup D belonging to ST69, ST393 and ST405 clonal groups. BMC Microbiol 13:144. doi:10.1186/1471-2180-13-144.
    OpenUrlCrossRef
  21. 21.↵
    1. D’Andrea MM,
    2. Venturelli C,
    3. Giani T,
    4. Arena F,
    5. Conte V,
    6. Bresciani P,
    7. Rumpianesi F,
    8. Pantosti A,
    9. Narni F,
    10. Rossolini GM
    . 2011. Persistent carriage and infection by multidrug-resistant Escherichia coli ST405 producing NDM-1 carbapenemase: report on the first Italian cases. J Clin Microbiol 49:2755–2758. doi:10.1128/JCM.00016-11.
    OpenUrlAbstract/FREE Full Text
  22. 22.↵
    1. Jakobsen L,
    2. Hammerum AM,
    3. Hansen F,
    4. Fuglsang-Damgaard D
    . 2014. An ST405 NDM-4-producing Escherichia coli isolated from a Danish patient previously hospitalized in Vietnam. J Antimicrob Chemother 69:559–560. doi:10.1093/jac/dkt356.
    OpenUrlCrossRefPubMed
  23. 23.↵
    1. Alghoribi MF,
    2. Gibreel TM,
    3. Farnham G,
    4. Al Johani SM,
    5. Balkhy HH,
    6. Upton M
    . 2015. Antibiotic-resistant ST38, ST131 and ST405 strains are the leading uropathogenic Escherichia coli clones in Riyadh, Saudi Arabia. J Antimicrob Chemother 70:2757–2762. doi:10.1093/jac/dkv188.
    OpenUrlCrossRefPubMed
  24. 24.↵
    1. Ruiz SJ,
    2. Montealegre MC,
    3. Ruiz-Garbajosa P,
    4. Correa A,
    5. Briceño DF,
    6. Martinez E,
    7. Rosso F,
    8. Muñoz M,
    9. Quinn JP,
    10. Cantón R,
    11. Villegas MV
    . 2011. First characterization of CTX-M-15-producing Escherichia coli ST131 and ST405 clones causing community-onset infections in South America. J Clin Microbiol 49:1993–1996. doi:10.1128/JCM.00045-11.
    OpenUrlAbstract/FREE Full Text
  25. 25.↵
    1. Mihaila L,
    2. Wyplosz B,
    3. Clermont O,
    4. Garry L,
    5. Hipeaux MC,
    6. Vittecoq D,
    7. Dussaix E,
    8. Denamur E,
    9. Branger C
    . 2010. Probable intrafamily transmission of a highly virulent CTX-M-3-producing Escherichia coli belonging to the emerging phylogenetic subgroup D2 O102-ST405 clone. J Antimicrob Chemother 65:1537–1539. doi:10.1093/jac/dkq155.
    OpenUrlCrossRefPubMedWeb of Science
PreviousNext
Back to top
Download PDF
Citation Tools
Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States
José R. Mediavilla, Amee Patrawalla, Liang Chen, Kalyan D. Chavda, Barun Mathema, Christopher Vinnard, Lisa L. Dever, Barry N. Kreiswirth
mBio Aug 2016, 7 (4) e01191-16; DOI: 10.1128/mBio.01191-16

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Print

Alerts
Sign In to Email Alerts with your Email Address
Email

Thank you for sharing this mBio article.

NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. We do not retain these email addresses.

Enter multiple addresses on separate lines or separate them with commas.
Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States
(Your Name) has forwarded a page to you from mBio
(Your Name) thought you would be interested in this article in mBio.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Share
Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States
José R. Mediavilla, Amee Patrawalla, Liang Chen, Kalyan D. Chavda, Barun Mathema, Christopher Vinnard, Lisa L. Dever, Barry N. Kreiswirth
mBio Aug 2016, 7 (4) e01191-16; DOI: 10.1128/mBio.01191-16
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Top
  • Article
    • ABSTRACT
    • Observation
    • ACKNOWLEDGMENTS
    • FOOTNOTES
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

Cited By...

About

  • About mBio
  • Editor in Chief
  • Board of Editors
  • AAM Fellows
  • Policies
  • For Reviewers
  • For the Media
  • For Librarians
  • For Advertisers
  • Alerts
  • RSS
  • FAQ
  • Permissions
  • Journal Announcements

Authors

  • ASM Author Center
  • Submit a Manuscript
  • Author Warranty
  • Article Types
  • Ethics
  • Contact Us

Follow #mBio

@ASMicrobiology

       

ASM Journals

ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology.

About ASM | Contact Us | Press Room

 

ASM is a member of

Scientific Society Publisher Alliance

 

American Society for Microbiology
1752 N St. NW
Washington, DC 20036
Phone: (202) 737-3600

Copyright © 2021 American Society for Microbiology | Privacy Policy | Website feedback

Online ISSN: 2150-7511