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      Colistin resistant Escherichia coli carrying mcr- 1 in urban sludge samples: Dhaka, Bangladesh

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          Abstract

          Of 48 bacteria belonging to the family Enterobacteriaceae tested from urban sludge samples, one Escherichia coli isolate was resistant to colistin and possessed the resistance marker gene mcr- 1 found for the first time from Bangladesh. The colistin resistant E. coli was multidrug resistant showing resistance to 11 different antibiotics tested.

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          Plasmid-mediated colistin resistance (mcr-1 gene): three months later, the story unfolds.

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            Comparative evaluation of the VITEK 2, disk diffusion, etest, broth microdilution, and agar dilution susceptibility testing methods for colistin in clinical isolates, including heteroresistant Enterobacter cloacae and Acinetobacter baumannii strains.

            Increasing antibiotic resistance in gram-negative bacteria has recently renewed interest in colistin as a therapeutic option. The increasing use of colistin necessitates the availability of rapid and reliable methods for colistin susceptibility testing. We compared seven methods of colistin susceptibility testing (disk diffusion, agar dilution on Mueller-Hinton [MH] and Isosensitest agar, Etest on MH and Isosensitest agar, broth microdilution, and VITEK 2) on 102 clinical isolates collected from patient materials during a selective digestive decontamination or selective oral decontamination trial in an intensive-care unit. Disk diffusion is an unreliable method to measure susceptibility to colistin. High error rates and low levels of reproducibility were observed in the disk diffusion test. The colistin Etest, agar dilution, and the VITEK 2 showed a high level of agreement with the broth microdilution reference method. Heteroresistance for colistin was observed in six Enterobacter cloacae isolates and in one Acinetobacter baumannii isolate. This is the first report of heteroresistance to colistin in E. cloacae isolates. Resistance to colistin in these isolates seemed to be induced upon exposure to colistin rather than being caused by stable mutations. Heteroresistant isolates could be detected in the broth microdilution, agar dilution, Etest, or disk diffusion test. The VITEK 2 displayed low sensitivity in the detection of heteroresistant subpopulations of E. cloacae. The VITEK 2 colistin susceptibility test can therefore be considered to be a reliable tool to determine susceptibility to colistin in isolates of genera that are known not to exhibit resistant subpopulations. In isolates of genera known to (occasionally) exhibit heteroresistance, an alternative susceptibility testing method capable of detecting heteroresistance should be used.
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              Comparison of disc diffusion, Etest and agar dilution for susceptibility testing of colistin against Enterobacteriaceae.

              In this study, we compared different methods of colistin susceptibility testing, disc diffusion, agar dilution and Etest using a set of Enterobacteriaceae isolates that included colistin-resistant strains.
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                Author and article information

                Contributors
                aminul0118@gmail.com
                zillur.rahman@icddrb.org
                smonira@icddrb.org
                anis.geb.cu@gmail.com
                Andrew.Camilli@tufts.edu
                cgeorg19@jhu.edu
                niyaz.ahmed@icddrb.org
                +880-2-9827001 , munirul@icddrb.org
                Journal
                Gut Pathog
                Gut Pathog
                Gut Pathogens
                BioMed Central (London )
                1757-4749
                20 December 2017
                20 December 2017
                2017
                : 9
                : 77
                Affiliations
                [1 ]ISNI 0000 0004 0600 7174, GRID grid.414142.6, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), ; Mohakhali, Dhaka, 1212 Bangladesh
                [2 ]GRID grid.449503.f, Department of Biotechnology and Genetic Engineering, , Noakhali Science and Technology University, ; Noakhali, 3814 Bangladesh
                [3 ]Department of Molecular Biology and Microbiology, Howard Hughes Medical Institute, TuftsUniversity School of Medicine, Boston, USA
                [4 ]ISNI 0000 0001 2171 9311, GRID grid.21107.35, Johns Hopkins Bloomberg School of Public Health, ; Baltimore, USA
                Article
                227
                10.1186/s13099-017-0227-4
                5738163
                29270234
                483a38f3-0164-46f7-807a-d8782daa0b83
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 November 2017
                : 16 December 2017
                Funding
                Funded by: National Institutes of Infectious Diseases (NIID), Japan
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Categories
                Letter to the Editor
                Custom metadata
                © The Author(s) 2017

                Gastroenterology & Hepatology
                colistin resistant,escherichia coli,mcr-1,bangladesh,first report
                Gastroenterology & Hepatology
                colistin resistant, escherichia coli, mcr-1, bangladesh, first report

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