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The global distribution and spread of the mobilized colistin resistance gene mcr-1

Wang R., van Dorp L., Shaw L.P., Bradley P., Wang Q., Wang X., Jin L., Zhang Q., Liu Y., Rieux A., Dorai-Schneiders T., Weinert L.A., Iqbal Z., Didelot X., Wang H., Balloux F.. 2018. Nature Communications, 9 (1) : 9 p..

DOI: 10.1038/s41467-018-03205-z

Colistin represents one of the few available drugs for treating infections caused by carbapenem-resistant Enterobacteriaceae. As such, the recent plasmid-mediated spread of the colistin resistance gene mcr-1 poses a significant public health threat, requiring global monitoring and surveillance. Here, we characterize the global distribution of mcr-1 using a data set of 457 mcr-1-positive sequenced isolates. We find mcr-1 in various plasmid types but identify an immediate background common to all mcr-1 sequences. Our analyses establish that all mcr-1 elements in circulation descend from the same initial mobilization of mcr-1 by an ISApl1 transposon in the mid 2000s (2002–2008; 95% highest posterior density), followed by a marked demographic expansion, which led to its current global distribution. Our results provide the first systematic phylogenetic analysis of the origin and spread of mcr-1, and emphasize the importance of understanding the movement of antibiotic resistance genes across multiple levels of genomic organization.

Mots-clés : enterobacteriaceae; infection; résistance aux antibiotiques; colistine; génétique; santé publique; maladie de l'homme

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