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Diseases caused by multidrug-resistant (MDR) bacteria continue to challenge physicians and endanger their patients’ lives. Polymyxins, including colistin, are the last resort antibiotics to treat serious infections caused by carbapenem-resistant bacteria. The aim of this study is to explore the resistance of Gram negative isolates recovered from 200 clinical specimens to carbapenem and colistin antibiotics, and the prevalence of plasmid-mediated mcr-1 gene in the resistant isolates. Clinical specimens were collected from two teaching hospitals and two private clinical laboratories in Cairo, Egypt. We identified one hundred and thirty isolates as Gram negative. These isolates were screened for their susceptibility to β-lactams antibiotics, carbapenems, colistin, polymyxin B, levofloxacin and amikacin. Thirty isolates were found to be resistant to the tested carbapenems. Of these, five isolates were found to be resistant to both carbapenem and colistin. They were tested for the presence of mcr-1, pmrB and pmrA genes; known to be among the reasons for colistin resistance. One isolate showed the presence of pmrA while three isolates showed the presence of pmrA and pmrB. Only one isolate showed the presence of mcr-1, pmrA and pmrB. This was tested by real time PCR to ensure the activity of this plasmid-mediated gene. Using 16S rRNA sequencing, the isolate showed 100% similarity to Escherichia coli strain K12 (MG1655). Here, we report a carbapenem-resistant and colistin-resistant Escherichia coli strain producing mcr-1gene that is the first to be reported in Egypt between human.

Association of Carbapenem and Colistin Resistance in Pathogenic Gram Negative Bacteria