Resistance to polymyxins in Gram-negative organisms

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Katy Jeannot1, Arnaud Bolard1, Patrick Plésiat1

  • 1Laboratoire de bactériologie, Centre national de référence (CNR) de la résistance aux antibiotiques, Centre hospitalier universitaire (CHRU) de Besançon, boulevard Fleming, 25000 Besançon, France.

International Journal of Antimicrobial Agents
|February 7, 2017
PubMed

Insights

Polymyxins are crucial for treating multidrug-resistant Gram-negative bacterial infections. However, increasing polymyxin resistance, especially plasmid-mediated resistance via mcr genes, is a growing global health concern.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Polymyxins are vital last-resort antibiotics for multidrug-resistant Gram-negative bacterial infections.
  • Emerging polymyxin resistance poses a significant global health threat.
  • Understanding resistance mechanisms is crucial for effective treatment strategies.

Purpose of the Study:

  • To review intrinsic and transferable polymyxin resistance mechanisms.
  • To analyze epidemiological data for key pathogens like Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa.
  • To highlight the role of plasmid-mediated resistance and mcr genes.

Main Methods:

  • Literature review of polymyxin resistance mechanisms.
  • Analysis of epidemiological studies on Gram-negative pathogens.
  • Focus on genetic determinants of resistance, particularly plasmid-borne genes.

Main Results:

  • Characterization of both intrinsic and transferable polymyxin resistance mechanisms.
  • Identification of increasing prevalence of resistant strains globally.
  • Emphasis on the significant role of mobile genetic elements, especially mcr genes, in resistance dissemination.

Conclusions:

  • Polymyxin resistance is a critical and escalating challenge.
  • Plasmid-mediated resistance, particularly mcr genes, is a major driver of spread.
  • Continued surveillance and research are essential to combat this threat.
Keywords:
Acinetobacter baumanniiColistin resistanceEnterobacteriaceaeMCR-1Pseudomonas aeruginosaTwo-components systems

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