PDF(Pubmed)
Abstract：
UNASSIGNED: In Laos, colistin is not currently registered for use in humans. This One Health study aimed to estimate the prevalence of meat-producing pigs carrying colistin-resistant Escherichia coli, and investigate if E. coli causing invasive human infections were colistin-resistant.
UNASSIGNED: Between September 2022 and March 2023, rectal swabs were collected from 895 pigs from abattoirs in 9/17 Lao provinces. Pig rectal swabs and stored E. coli isolates from human blood cultures, submitted to Mahosot Hospital Microbiology laboratory between 2005 and 2022, were screened for colistin resistance on selective chromogenic agar with organism identification confirmed using MALDI-TOF MS. Suspected colistin-resistant isolates underwent colistin susceptibility testing by broth microdilution following European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Isolates with MIC values of ≥2 μg/ml were tested for plasmid-mediated colistin resistance genes (mcr-1, mcr-2, and mcr-3) by multiplex SYBR Green PCR.
UNASSIGNED: A total of 15/620 (2.41%) invasive human E. coli isolates were phenotypically colistin-resistant by broth microdilution (MIC values 4 to 8 μg/ml). The earliest isolate was from 2015 in a patient from Phongsaly province in Northern Laos. A total of 582/895 (65.02%) pig rectal swab samples contained colistin-resistant E. coli. The detected colistin resistance genes were predominantly mcr-1 (57.8%, 346/598), followed by mcr-3 (20.23%,121/598), and 22.24% (133/598) were found to co-harbour mcr-1 and mcr-3. Among the 15 human isolates with colistin MIC values of ≥4 μg/ml, 12/15 were mcr-1.
UNASSIGNED: We found that colistin resistant E. coli is causing invasive infection in humans in Laos despite the fact it is not available for human use. Use in animals seems to be widespread, confirmed by high carriage rates of colistin-resistant E. coli in pigs. It is probable that food-producing animals are the source of colistin-resistant E. coli bloodstream infection in Laos, although these have been infrequent to date. This is a serious public health concern in the region that needs to be addressed by appropriate enforceable legislation.
UNASSIGNED: Between September 2022 and March 2023, rectal swabs were collected from 895 pigs from abattoirs in 9/17 Lao provinces. Pig rectal swabs and stored E. coli isolates from human blood cultures, submitted to Mahosot Hospital Microbiology laboratory between 2005 and 2022, were screened for colistin resistance on selective chromogenic agar with organism identification confirmed using MALDI-TOF MS. Suspected colistin-resistant isolates underwent colistin susceptibility testing by broth microdilution following European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Isolates with MIC values of ≥2 μg/ml were tested for plasmid-mediated colistin resistance genes (mcr-1, mcr-2, and mcr-3) by multiplex SYBR Green PCR.
UNASSIGNED: A total of 15/620 (2.41%) invasive human E. coli isolates were phenotypically colistin-resistant by broth microdilution (MIC values 4 to 8 μg/ml). The earliest isolate was from 2015 in a patient from Phongsaly province in Northern Laos. A total of 582/895 (65.02%) pig rectal swab samples contained colistin-resistant E. coli. The detected colistin resistance genes were predominantly mcr-1 (57.8%, 346/598), followed by mcr-3 (20.23%,121/598), and 22.24% (133/598) were found to co-harbour mcr-1 and mcr-3. Among the 15 human isolates with colistin MIC values of ≥4 μg/ml, 12/15 were mcr-1.
UNASSIGNED: We found that colistin resistant E. coli is causing invasive infection in humans in Laos despite the fact it is not available for human use. Use in animals seems to be widespread, confirmed by high carriage rates of colistin-resistant E. coli in pigs. It is probable that food-producing animals are the source of colistin-resistant E. coli bloodstream infection in Laos, although these have been infrequent to date. This is a serious public health concern in the region that needs to be addressed by appropriate enforceable legislation.
摘要：
■在老挝，粘菌素目前尚未注册用于人类。这项一项健康研究旨在评估携带粘菌素抗性大肠杆菌的产肉猪的患病率，并调查引起侵袭性人类感染的大肠杆菌是否对粘菌素耐药。
■在2022年9月至2023年3月之间，从老挝9/17省屠宰场的895头猪中收集了直肠拭子。猪直肠拭子和储存的来自人类血液培养物的大肠杆菌分离物，在2005年至2022年之间提交给Mahosot医院微生物实验室，在选择性显色琼脂上筛选粘菌素抗性，并使用MALDI-TOFMS进行生物鉴定。根据欧洲抗菌药物敏感性测试委员会（EUCAST）指南，通过肉汤微量稀释对疑似粘菌素耐药的分离株进行了粘菌素敏感性测试。通过多重SYBRGreenPCR测试MIC值≥2μg/ml的分离株的质粒介导的粘菌素抗性基因（mcr-1，mcr-2和mcr-3）。
■通过肉汤微稀释(MIC值4至8μg/ml),总共15/620(2.41%)侵袭性人大肠杆菌分离株在表型上具有粘菌素抗性。最早的分离株是2015年在老挝北部丰沙里省的一名患者中。总共582/895(65.02%)猪直肠拭子样品含有粘菌素抗性大肠杆菌。检测到的粘菌素抗性基因主要是mcr-1(57.8%，346/598),其次是mcr-3(20.23%，121/598），发现22.24%(133/598)与mcr-1和mcr-3共存。在粘菌素MIC值≥4μg/ml的15种人类分离物中，12/15是mcr-1。
我们发现，耐粘菌素的大肠杆菌在老挝的人类中引起侵袭性感染，尽管它不能供人类使用。在动物中的使用似乎很普遍，猪粘菌素抗性大肠杆菌的高携带率证实。在老挝，食用动物可能是粘菌素抗性大肠杆菌血流感染的来源，尽管这些迄今为止很少见。这是该地区严重的公共卫生问题，需要通过适当的可执行立法加以解决。
■在2022年9月至2023年3月之间，从老挝9/17省屠宰场的895头猪中收集了直肠拭子。猪直肠拭子和储存的来自人类血液培养物的大肠杆菌分离物，在2005年至2022年之间提交给Mahosot医院微生物实验室，在选择性显色琼脂上筛选粘菌素抗性，并使用MALDI-TOFMS进行生物鉴定。根据欧洲抗菌药物敏感性测试委员会（EUCAST）指南，通过肉汤微量稀释对疑似粘菌素耐药的分离株进行了粘菌素敏感性测试。通过多重SYBRGreenPCR测试MIC值≥2μg/ml的分离株的质粒介导的粘菌素抗性基因（mcr-1，mcr-2和mcr-3）。
■通过肉汤微稀释(MIC值4至8μg/ml),总共15/620(2.41%)侵袭性人大肠杆菌分离株在表型上具有粘菌素抗性。最早的分离株是2015年在老挝北部丰沙里省的一名患者中。总共582/895(65.02%)猪直肠拭子样品含有粘菌素抗性大肠杆菌。检测到的粘菌素抗性基因主要是mcr-1(57.8%，346/598),其次是mcr-3(20.23%，121/598），发现22.24%(133/598)与mcr-1和mcr-3共存。在粘菌素MIC值≥4μg/ml的15种人类分离物中，12/15是mcr-1。
我们发现，耐粘菌素的大肠杆菌在老挝的人类中引起侵袭性感染，尽管它不能供人类使用。在动物中的使用似乎很普遍，猪粘菌素抗性大肠杆菌的高携带率证实。在老挝，食用动物可能是粘菌素抗性大肠杆菌血流感染的来源，尽管这些迄今为止很少见。这是该地区严重的公共卫生问题，需要通过适当的可执行立法加以解决。
