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MCR: modern colistin resistance

I Caniaux1, A van Belkum2, G Zambardi2

  • 1Medical Affairs, bioMérieux SA, 376, Chemin de l'Orme, 69280, Marcy L'Etoile, France.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|November 23, 2016
PubMed

Insights

Transferable polymyxin resistance in bacteria is emerging in humans and animals, threatening the effectiveness of last-resort antibiotics like colistin. Timely detection through diagnostics is crucial to combat this growing threat.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Plasmid-mediated, transferable polymyxin resistance has been identified in bacterial strains from human and animal sources.
  • This resistance mechanism poses a significant threat of geographic spread and inter-species transmission.
  • The rise of colistin resistance, particularly in Gram-negative carbapenemase producers, could lead to pan-antibiotic resistance, rendering critical treatments ineffective.

Purpose of the Study:

  • To analyze the medical and diagnostic implications of emerging colistin resistance.
  • To propose effective diagnostic strategies for the early detection of colistin resistance in both asymptomatic carriers and infected individuals.

Main Methods:

  • Review and analysis of current medical and diagnostic challenges posed by colistin resistance.
  • Discussion of culture-based diagnostic methods, including chromogenic and selective media for screening clinical and veterinary specimens.
  • Evaluation of relevant molecular diagnostic tests for detecting colistin resistance.

Main Results:

  • Emerging transferable colistin resistance presents a serious global health risk, potentially compromising the efficacy of polymyxin antibiotics.
  • Current diagnostic approaches need enhancement to effectively identify and manage colistin-resistant bacterial infections and carriage.
  • Culture-based and molecular tests are vital for timely detection and surveillance.

Conclusions:

  • Urgent development and implementation of adequate diagnostic tools are necessary to combat the spread of colistin resistance.
  • Effective diagnostics will aid in managing infections caused by resistant bacteria and preventing the loss of polymyxin efficacy.
  • A multi-faceted approach combining culture-based and molecular methods is recommended for comprehensive detection.

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