Emergence of mcr-9.1 in ESBL-producing Clinical Enterobacteriaceae in Pretoria, South Africa: Global Evolutionary Phylogenomics, Resistome and Mobilome.

MedRxiv : the Preprint Server for Health Sciences
John Osei SekyereNontombi Marylucy Mbelle


Background. Extended-spectrum {beta}-lactamase (ESBL)-producing Enterobacteriaceae are critical-priority pathogens that cause substantial fatalities. With the emergence of mobile mcr genes mediating resistance to colistin in Enterobacteriaceae, clinicians are now left with little therapeutic options. Methods. Eleven clinical Enterobacteriaceae strains with resistance to cephems and/or colistin were genomically analysed to determine their resistome, mobilome, and evolutionary relationship to global strains. The global phylogenomics of mcr-9.1-bearing genomes were further analysed. Results & conclusion. Ten isolates were ESBL positive. The isolates were multidrug-resistant and phylogenetically related to global clones, but distant from local strains. Multiple resistance genes, including blaCTX-M-15 blaTEM-1 and mcr-9.1 were found in single isolates; ISEc9, IS19, and Tn3 transposons bracketed blaCTX-M-15 and blaTEM-1. Common plasmid types included IncF, IncH and ColRNAI. Genomes bearing mcr-9.1 clustered into six main phyletic groups (A-F), with those of this study belonging to clade B. Enterobacter sp. and Salmonella sp. are the main hosts of mcr-9.1 globally, albeit diverse promiscuous plasmids disseminate mcr-9.1 across differe...Continue Reading

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