Colistin resistant Klebsiella pneumonia outbreak in Chinese Hospital
Earlier this month, MCR-1 was reported in multiple patients in an Italian hospital. Now, a group of Chinese clinicians have reported an outbreak of MCR-1 producing Klebsiella pneumonia in a paediatric leukaemia ward.
Published in June’s edition of The Lancet Infectious Diseases the communication identifies six children infected with either MCR-1 producing Escherichia coli (1 patient) or Klebsiella pneumonia (5 patients). MCR-1 is a gene that confers resistance to the antibiotic colistin, a powerful antibiotic often referred to as an “antibiotic of last resort”. The infected patients were treated with combinations of vancomycin, Imipenem, lincomycin, cefotaxime and caspofungin acetate. The infections were found to be multi-drug resistant and unresponsive to a wide range of antibiotics including colistin, gentamicin, polymyxin B, cefotaxime, ciprofloxacin, ceftazidime and amikacin. Unfortunately, two of the six patients died. The reporting clinicians concluded that the spread of the MCR-1 gene within the hospital environment can occur even without the use of colistin (i.e. the transmission of the MCR-1 gene can occur in the absence of a selective pressure).
This communication is yet further evidence of the levels of antibiotic resistance being found within hospitals. The number of reports and their global nature is also concerning. Since its identification in 2015, MCR-1 has been detected in over 30 countries.
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I have previously blogged about the colistin antibiotic resistance gene MCR-1 and its prevalence within agricultural animals such as cows, pigs, chickens, etc. This week, researchers in Guangzhou, China discovered a transmission link between domestic animals and humans.