Plasmid-borne colistin resistance gene mcr-1 in a multidrug resistant Salmonella enterica serovar Typhimurium isolate from an infant with acute diarrhea in China.

• Colistin is considered a last resort for treatment of MDR gram-negative bacteria. • The mcr -1-positive isolate revealed a multidrug-resistant phenotype. • pJZ26 harbors many resistance genes and has a high potential to disseminate the mcr-1 gene. • pJZ26 contains an additional 4.6 kb fragment harboring the resistance gene tet(A). • The regulator tetR of tet(A) located on Tn As1 transposable element. Antimicrobial resistance of Salmonella enterica is a major global concern. Recent findings suggest that colistin as a last resort treatment for multidrug-resistant gram-negative bacteria is seriously threatened by the report of plasmid-mediated colistin resistance gene mcr-1 in China. A total of 827 S. Typhimurium isolates were recovered from 4 cities of China, including Henan, Shanghai, Zhejiang, and Hubei provinces. Subsequently, mcr-1 presence was identified by PCR screening. Antimicrobial susceptibility testing was performed by broth microdilution using a 96-well microtiter plate. Plasmid conjugation transfer experiments were conducted using Escherichia coli J53 as the recipient. Only one mcr-1 positive strain from the stool sample of an infant with acute diarrhea was isolated. Apart from colistin, the mcr-1 -positive isolate showed co-resistance to the third-generation cephalosporins, ampicillin, nalidixic acid, tetracycline, chloramphenicol, sulfisoxazole, gentamicin, and cefotaxime revealing a multidrug-resistant phenotype. This strain harbored mcr-1 on a 227 kb IncHI2 plasmid, termed pJZ26, which could be transferred to E. coli J53. In addition to mcr-1 , pJZ26 coharbored other resistance genes, including aph(4)-Ia , aac(3)-IVa , fosA , floR , sul2 , and bla CTX-M-14. Compared with p2474-MCR1 and pHYEC7-IncHI2, pJZ26 contains an additional 4.6 kb fragment harboring the resistance gene tet(A) and its regulator tetR located on Tn As1 transposable element, which could mediate resistance to tetracycline. These findings highlight that the fact the mcr-1 –harboring plasmid pJZ26 has a high potential to disseminate the mcr-1 gene and further challenge the clinical treatment. [ABSTRACT FROM AUTHOR]