English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Objectives This study aimed to explore mechanism of colistin resistance amongst  Klebsiella pneumoniae  isolates through plasmid mediated  mcr-1  gene in Pakistan. Carbapenem and Colistin resistant  K. pneumoniae  isolates (n  = 34) stored at − 80 °C as part of the Aga Khan University Clinical Laboratory strain bank were randomly selected and subjected to  mcr-1  gene PCR. To investigate mechanisms of resistance, other than plasmid mediated  mcr-1  gene, whole genome sequencing was performed on 8 clinical isolates, including 6 with colistin resistance (MIC  &gt;  4 μg/ml) and 2 with intermediate resistance to colistin (MIC  &gt;  2 μg/ml). Results RT-PCR conducted revealed absence of  mcr-1  gene in all isolates tested. Whole genome sequencing results revealed modifications in Lipid A-Ara4N pathway. Modifications in Lipid A-Ara4N pathway were detected in  ArnA_ DH/FT, UgdH ,  ArnC  and  ArnT  genes. Mutation in  ArnA_ DH/FT  gene were detected in S3, S5, S6 and S7 isolates.  UgdH  gene modifications were found in all isolates except S3, mutations in  ArnC  were present in all except S1, S2 and S8 and ArnT were detected in all except S4 and S7. In the absence of known mutations linked with colistin resistance, lipid pathway modifications may possibly explain the phenotype resistance to colistin, but this needs further exploration.

Lipid A-Ara4N as an alternate pathway for (colistin) resistance in Klebsiella pneumonia isolates in Pakistan