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To investigate the prevalence, probable mechanisms and serotype correlation of colistin resistance in clinical isolates of  Salmonella  from patients in China,  Salmonella  isolates were collected from fecal and blood samples of patients. In this study, 42.8% (136/318) clinical isolated  Salmonella  were resistant to colistin. MIC distribution for colistin at serotype level among the two most prevalent serotypes originating from humans in China indicated that  Salmonella  Enteritidis (83.9% resistance, 125/149) were significantly less susceptible than  Salmonella  Typhimurium (15.3% resistance, 9/59,  P  < 0.01).  mcr  genes and mutations in PmrAB confer little for rate of colistin resistant  Salmonella  isolated from human patients. Phylogenetic tree based on core-genome single nucleotide polymorphisms (SNPs) was separately by the serotypes and implied a diffused distribution of MICs in the same serotype isolates. Relatvie expression levels of colistin resistant related  pmr  genes were significantly higher in non- mcr  colistin resistant  S.  Typhimurium than in colistin sensitive  S.  Typhimurium, but no discernable differences between colistin resistant and sensitive  S.  Enteritidis, indicating a different mechanism between colistin resistant  S.  Typhimurium and  S.  Enteritidis. In conclusion, colistin susceptibility and colistin resistant mechanism of clinical isolated  Salmonella  were closely associated with specific serotypes, at least in the two most prevalent serotype Enteritidis and Typhimurium. We suggest clinical microbiology laboratory interpreting  Salmonella  colistin MIC results in the serotype level.

Serotype Is Associated With High Rate of Colistin Resistance Among Clinical Isolates of Salmonella