May 27, 2016

expert reaction to study reporting that colistin-resistant bacteria have been detected in the urinary tract infection of a woman in the US

Publishing in the journal Antimicrobial Agents and Chemotherapy a group of scientists have reported the identification of E. coli resistant to the anti-microbial compound colistin.

Prof. Laura Piddock, Professor of Microbiology, University of Birmingham, said:

“The bacterium described was isolated from a patient with a urinary tract infection. The drug of choice for these infections is not colistin and so the presence of this resistance is unlikely to have affected treatment. One of the drugs that is used to treat UTIs is nitrofurantoin. The UTI would have been treatable with 400mg/day nitrofurantoin.”

Dr Paul Hoskisson, Senior Lecturer, University of Strathclyde, said:

“While this study is significant in showing that the mcr-1 gene is truly global, this development is not unexpected. The work highlights the worldwide nature of antimicrobial resistant infections – a drug resistance mechanism that was only discovered six months ago in Asia has already been found in samples in the EU and now in a patient in the USA.

“The work also highlights the promiscuity of bacteria, which are able to quickly and easily share resistance mechanisms between species. Careful surveillance is now needed to see how far the mcr-1 gene has spread. Antimicrobial resistance is inevitable, so we need to better understand how these resistance mechanisms are transmitted in the environment through basic research, if we are to preserve the lifespan of the antibiotics we have left.”

‘Escherichia coli Harboring mcr-1 and blaCTX-M on a Novel IncF Plasmid: First report of 2 mcr-1 in the USA’ by McGann et al. published in Antimicrobial Agents and Chemotherapy.

Declared interests

Prof. Laura Piddock: For her basic research, Prof Piddock is currently in receipt of funding from the BBSRC and MRC, and has a Roche Extending the Innovation Network Award. Prof Piddock is the vice-chair of the EU Joint Programming Initiative on AMR scientific advisory board. She is also member of the Longitude Prize Advisory panel.

Dr Paul Hoskisson: No conflicts of interest