Plasmid-encoded colistin resistance is emerging among extra-intestinal pathogenic Escherichia coli including the epidemic clone ST131-H30. Mcr-1 transfers a phosphoethanolamine to the lipid A portion of LPS conferring resistance to polymyxins. We investigated whether this modification changed the activity of the monoclonal antibody, ASN-4 specific to the O25b side-chain of ST131 LPS. We confirmed that, unlike colistin, ASN-4 retained its bactericidal and endotoxin neutralizing activity and therefore offer a treatment option against extremely drug-resistant ST131 isolates.
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