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Objective  Colistin resistance has emerged worldwide and has been threatening the efficacy of one of the last-resort antimicrobials used for treatment of multidrug resistant Gram-negative bacteria. While five colistin resistance genes ( mcr - 1 ,  mcr - 2 ,  mcr - 3 ,  mcr - 4  and  mcr - 5 ) have been described, few data are available on the prevalence of  mcr -genes other than  mcr - 1  in human samples.    Results  In this study, the presence of five currently described colistin resistance genes ( mcr 1 – 5 ) in vaginal swabs of women undergoing infertility evaluation was reported. Most samples were found to be positive for the  mcr - 4  (12.7%), followed by two for the  mcr - 2  (1.5%), two for the  mcr - 3  (1.5%), one for the  mcr - 1  (0.7%), and one for the  mcr - 5  (0.7%). Phylogenetic comparison demonstrated identical ( mcr - 1 ,  mcr - 2 ,  mcr - 3 ,  mcr - 5 ) or similar ( mcr - 4 ) nucleotide sequences of human samples and those of animal origins from the same city, suggesting the potential transmission of  mcr  genes from animals to humans. This is the first detection of  mcr - 2 ,  mcr - 4  and  mcr - 5  genes in human samples, and warrants further research to determine the spread of the  mcr  genes and elucidate the full epidemiology of colistin resistance genes in humans.

Molecular detection of colistin resistance genes (mcr-1 to mcr-5) in human vaginal swabs