Two Novel Mutations Associated with Polymyxin-B Resistance in a Pandemic Lineage of Uropathogenic Escherichia coli of the Sequence Type 69

Chemotherapy. 2021;66(3):92-98. doi: 10.1159/000517817. Epub 2021 Jul 29.

Abstract

Background: Uropathogenic Escherichia coli (UPEC) are frequent pathogens worldwide, impacting on the morbidity and economic costs associated with antimicrobial treatment.

Objectives: We report two novel mutations associated with polymyxin-B resistance in an UPEC isolate collected in 2019.

Methods: Isolate was submitted to antimicrobial susceptibility testing including broth microdilution for polymyxin B. Whole genome was sequenced and analyzed.

Results: Polymyxin-B total inhibition occurred at 16 mg/L (resistant). UPEC isolate was assigned to the phylogroup D, serotype O117:H4, and Sequence Type 69. mcr genes were not detected, but two novel mutations in the pmrA/basS (A80S) and pmrB/basR (D149N) genes were identified.

Conclusions: The occurrence of non-mcr polymyxin resistance in E. coli from extraintestinal infections underscores the need of a continuous surveillance of this evolving pathogen.

Keywords: Antimicrobial resistance; Escherichia coli; Polymyxin B; Uropathogenic Escherichia coli; Whole-genome sequencing.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Humans
  • Mutation
  • Phylogeny
  • Polymyxin B / pharmacology
  • Transcription Factors / genetics*
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / pathology
  • Uropathogenic Escherichia coli / classification
  • Uropathogenic Escherichia coli / drug effects
  • Uropathogenic Escherichia coli / genetics*
  • Uropathogenic Escherichia coli / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • PmrB protein, bacteria
  • Transcription Factors
  • pmrA protein, Bacteria
  • Polymyxin B