MCR: modern colistin resistance

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.