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Volume 22, Number 9—September 2016
Letter

Colistin-Resistant Enterobacteriaceae Carrying the mcr-1 Gene among Patients in Hong Kong

Sally C.Y. Wong, Herman Tse, Jonathan H.K. Chen, Vincent C.C. Cheng, Pak-Leung Ho, and Patrick C.Y. WooComments to Author 
Author affiliations: Queen Mary Hospital, Hong Kong, China (S.C.Y. Wong, J.H.K. Chen, V.C.C. Cheng); The University of Hong Kong, Hong Kong (H. Tse, P.-L. Ho, K.-Y. Yuen)

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Table

Clinical details of 5 patients infected with mcr-1–carrying Enterobacteriaceae, Hong Kong*

Patient ID† (age, y) Underlying conditions Time from admission to collection of specimen (specimen type) Antimicrobial drug use <1 mo before isolation Outcome mcr-1–positive species (colistin MIC, µg/mL)
1 (55) Acute myeloid leukemia 4 mo after bone marrow transplant 4 mo (stool sample‡) Pipericillin/ tazobactam, meropenem Asymptomatic colonization Enterobacter cloacae complex (64)
2 (68) Primary sclerosing cholangitis with liver transplant in China in 2004; currently on sirolimus and prednisolone; right hepatectomy in 2008 for right diffuse ischemic bile injury; history of recurrent cholangitis On admission with sepsis workup for biliary sepsis resulting from biliary anastomotic stricture (blood culture) None Recovered Escherichia coli (3)
3 (2) Autologous bone marrow transplant for stage IV neuroblastoma 14 d (stool sample‡) Pipericillin/ tazobactam Asymptomatic colonization E. coli (3)
4 (57) Hepatitis B virus–related hepatocellular carcinoma; recurrent pyogenic cholangitis; recurrent biliary sepsis with portal vein thrombosis; cerebellar stroke in 2013 On admission with sepsis workup for biliary sepsis resulting from biliary stricture and recent transarterial chemoembolization (blood culture) None Recovered ESBL-producing E. coli (4)
5 (80) Duke’s B carcinoma of rectum [lower anterior resection in 1996]; carcinoma of thyroid [post-thyroidectomy]; hypertension; diabetes mellitus On admission with sepsis workup for symptomatic urinary tract infection
(mid-stream urine sample) None Recovered E. coli (4)

*ID, identifier; ESBL, extended-spectrum β-lactamase.
†Patient 4 was male; others were female.
‡Routine surveillance of stool samples for multidrug-resistant organisms according to infection control protocol (4).

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References
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