mcr-1基因是迄今为止国际上首次发现的质粒介导的黏菌素耐药基因,可介导肠杆菌科细菌对多粘菌素类药物产生耐药并可通过质粒进行水平转移。最新研究表明该基因已通过IncI2、IncX4和IncHI2等流行性质粒以及可移动元件,在全球35个不同国家和地区的人、动物和环境源多种肠杆菌中广泛传播。这些研究对于深入了解mcr-1基因介导的黏菌素耐药和传播机制、全球流行分布特征奠定了基础,丰富了耐药性形成理论。文章主要介绍了不同来源肠杆菌科细菌中mcr-1的分布流行情况、耐药和传播机制、基因环境等方面的研究进展,探讨了其临床风险性以及后续应对措施,以期为相关科研人员和临床工作者提供参考,共同应对抗生素耐药日益严峻的局面。

mcr-1, the first plasmid-mediated colistin-resistance gene, can mediate polymyxin resistance and be transferred horizontally via plasmids. Many studies have confirmed its distribution via epidemic plasmids (IncI2, IncX4, IncHI2, etc.), as well as mobile genetic elements, among Enterobacteriaceae isolated from animals, humans, and the environment in 35 countries. These studies provide the basis of understanding the complicated mechanism of colistin resistance mediated by MCR-1 and its global dissemination and epidemic properties, and also enrich antimicrobial resistance mechanisms. Here, we review the latest advances in the prevalence, resistance mechanism, transfer mechanism, and genetic environments of mcr-1 in isolates recovered from various samples worldwide. Finally, we discuss the clinical risk and the corresponding solutions, aiming to provide a basis for researchers and clinical scientists to face the serious challenge of antimicrobial resistance together.