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Title: Colistin-resistance gene mcr in clinical carbapenem-resistant Enterobacteriaceae strains in China, 2014-2019
Authors: Huang, H
Dong, N
Shu, LB
Lu, JY
Sun, QL
Chan, EWC 
Chen, S
Zhang, R
Issue Date: 2020
Source: Emerging microbes & infections, 2020, v. 9, no. 1, p. 237-245
Abstract: To investigate whether introduction of colistin into the clinical settings selected colistin-resistant CRE, we performed molecular epidemiological study of 1868 CRE strains collected from different geographical locales in China during the period 2014-2019. 1755 (96.18%) isolates carried the carbapenemase genes bla(KPC) and bla(NDM); 14 Escherichia coli isolates (0.75%) carrying mcr-1 and bla(NDM) (MCR-CREC) were also identified. Importantly, the number and relative prevalence of MCR-CREC isolates increased from 5 (0.41%) to 9 (1.38%) after introduction of polymyxin into clinical practice. Consistently, results of genetic analysis indicated that MCR-CREC strains collected before December 2017 were genetically diverse, yet those collected after that date exhibited more closely related genetic profiles, indicating that specific MCR-CREC strains were rapidly selected as a result of increased usage of colistin in clinical settings. The resistance level of MCR-CREC isolates to colistin increased after the introduction of polymyxin into clinical use with the MIC to colistin from <2 mg/L in 80% strains to 2 mg/L in 100% strains. Further dissemination of MCR-CREC strains, which exhibit resistance to the last-line drugs of carbapenems and colistin, is expected to pose a severe threat to human health.
Keywords: Carbapenem-resistant enterobacteriaceae
Clinical uses
Publisher: Taylor & Francis
Journal: Emerging microbes & infections 
EISSN: 2222-1751
DOI: 10.1080/22221751.2020.1717380
Rights: © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, on behalf of Shanghai Shangyixun Cultural Communication Co., LtdThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricteduse, distribution, and reproduction in any medium, provided the original work is properly cited.
The following publication Hong Huang, Ning Dong, Lingbin Shu, Jiayue Lu, Qiaoling Sun, Edward Wai-Chi Chan, Sheng Chen & Rong Zhang (2020) Colistin-resistance gene mcr in clinical carbapenem-resistant Enterobacteriaceae strains in China, 2014–2019, Emerging Microbes & Infections, 9:1,237-245 is available at
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