TY - JOUR
T1 - Reduction trend of mcr-1 circulation in Emilia-Romagna Region, Italy
AU - Gagliotti, Carlo
AU - Bolzoni, Luca
AU - Carretto, Edoardo
AU - Sarti, Mario
AU - Ricchizzi, Enrico
AU - Ambretti, Simone
AU - Barozzi, Agostino
AU - Bracchi, Chiara
AU - Confalonieri, Massimo
AU - Menozzi, Ilaria
AU - Morganti, Marina
AU - Pedna, Maria Federica
AU - Sambri, Vittorio
AU - Scaltriti, Erika
AU - Schiavo, Roberta
AU - Soliani, Laura
AU - Tambassi, Martina
AU - Venturelli, Claudia
AU - Biagetti, Carlo
AU - Buttazzi, Rossella
AU - Calderaro, Adriana
AU - Casadio, Chiara
AU - Meschiari, Marianna
AU - Tumietto, Fabio
AU - Diegoli, Giuseppe
AU - Pongolini, Stefano
AU - Moro, Maria Luisa
N1 - Funding Information:
Work done at the Risk Analysis and Genomic Epidemiology Unit, IZSLER, was supported by the Italian Ministry of Health (grant numbers PRC2016004 and PRC2017001) and by the One Health European Joint Programme (OHEJP) grant number 773830 (COHESIVE project).
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/12
Y1 - 2021/12
N2 - This study aims to describe trends of mcr-positive Enterobacterales in humans based on laboratory surveillance with a defined catchment population. The data source is the Micro-RER surveillance system, established in Emilia-Romagna region (Italy), to monitor the trend of mcr resistance. Enterobacterales isolates from human clinical samples with minimum inhibitory concentration (MIC) ≥ 2 mg/L for colistin were sent to the study reference laboratory for the detection of mcr genes. Isolates prospectively collected in the period 2018–2020 were considered for the assessment of population rates and trends; further analyses were carried out for the evaluation of clonality and horizontal mcr gene transfer. Previous isolates from local laboratory collection were also described. In the period 2018–2020, 1164 isolates were sent to the reference laboratory, and 51 (4.4%) were confirmed as mcr-positive: 50 mcr-1 (42 Escherichia coli, 6 Klebsiella pneumoniae, 2 Salmonella enterica) and 1 mcr-4 (Enterobacter cloacae). The number of mcr-positive isolates dropped from 24 in the first half of 2018 to 3 in the whole of 2020 (trend p value < 0.001). Genomic analyses showed the predominant role of the horizontal transfer of mcr genes through plasmids or dissemination of transposable elements compared to clonal dissemination of mcr-positive microorganisms. The study results demonstrate a substantial decrease in the circulation of mcr-1 plasmid genes in Emilia-Romagna Region.
AB - This study aims to describe trends of mcr-positive Enterobacterales in humans based on laboratory surveillance with a defined catchment population. The data source is the Micro-RER surveillance system, established in Emilia-Romagna region (Italy), to monitor the trend of mcr resistance. Enterobacterales isolates from human clinical samples with minimum inhibitory concentration (MIC) ≥ 2 mg/L for colistin were sent to the study reference laboratory for the detection of mcr genes. Isolates prospectively collected in the period 2018–2020 were considered for the assessment of population rates and trends; further analyses were carried out for the evaluation of clonality and horizontal mcr gene transfer. Previous isolates from local laboratory collection were also described. In the period 2018–2020, 1164 isolates were sent to the reference laboratory, and 51 (4.4%) were confirmed as mcr-positive: 50 mcr-1 (42 Escherichia coli, 6 Klebsiella pneumoniae, 2 Salmonella enterica) and 1 mcr-4 (Enterobacter cloacae). The number of mcr-positive isolates dropped from 24 in the first half of 2018 to 3 in the whole of 2020 (trend p value < 0.001). Genomic analyses showed the predominant role of the horizontal transfer of mcr genes through plasmids or dissemination of transposable elements compared to clonal dissemination of mcr-positive microorganisms. The study results demonstrate a substantial decrease in the circulation of mcr-1 plasmid genes in Emilia-Romagna Region.
KW - Antibiotic resistance
KW - Antimicrobials for veterinary use
KW - Clonal dissemination
KW - Colistin
KW - Enterobacterales
KW - Horizontal transfer
KW - Humans
KW - Mcr
KW - One Health approach
UR - http://www.scopus.com/inward/record.url?scp=85111907947&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111907947&partnerID=8YFLogxK
U2 - 10.1007/s10096-021-04318-y
DO - 10.1007/s10096-021-04318-y
M3 - Article
C2 - 34351529
AN - SCOPUS:85111907947
VL - 40
SP - 2585
EP - 2592
JO - European Journal of Clinical Microbiology and Infectious Diseases
JF - European Journal of Clinical Microbiology and Infectious Diseases
SN - 0934-9723
IS - 12
ER -