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Testing the Role of Multicopy Plasmids in the Evolution of Antibiotic Resistance
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Testing the Role of Multicopy Plasmids in the Evolution of Antibiotic Resistance

Published on: May 2, 2018

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Polymyxins: Antibacterial Activity, Susceptibility Testing, and Resistance Mechanisms Encoded by Plasmids or

Laurent Poirel1,2,3, Aurélie Jayol4,2,3, Patrice Nordmann4,2,3,5

  • 1Emerging Antibiotic Resistance Unit, Medical and Molecular Microbiology, Department of Medicine, University of Fribourg, Fribourg, Switzerland laurent.poirel@unifr.ch.

Clinical Microbiology Reviews
|March 10, 2017
PubMed

Insights

Polymyxins like colistin are crucial last-resort antibiotics against multidrug-resistant Gram-negative bacteria. This review details polymyxin resistance mechanisms, testing methods, and epidemiology.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Polymyxins (colistin, polymyxin B) are vital antibiotics for multidrug-resistant Gram-negative bacterial infections.
  • Increased resistance necessitates reconsidering their use in human and veterinary medicine.
  • Emergence of resistance, including plasmid-mediated MCR-1, poses a significant public health threat.

Purpose of the Study:

  • To review current polymyxin susceptibility testing methods for diagnostic laboratories.
  • To summarize recent findings on polymyxin resistance mechanisms.
  • To present epidemiological data on polymyxin resistance.

Main Methods:

  • Review of genotypic and phenotypic polymyxin susceptibility testing techniques.
  • Analysis of recent literature on polymyxin resistance mechanisms.
  • Compilation of epidemiological data on polymyxin-resistant bacteria.

Main Results:

  • Susceptibility testing for polymyxins is challenging but crucial.
  • Mechanisms of resistance include chromosomal and plasmid-encoded traits (e.g., MCR-1).
  • Epidemiological data highlights the growing global concern.

Conclusions:

  • Effective polymyxin susceptibility testing is essential for clinical decision-making.
  • Understanding resistance mechanisms is key to combating infections.
  • Continued surveillance and stewardship are critical for preserving polymyxin efficacy.
Keywords:
Gram-negative bacteriaMCR-1lipopolysaccharidepolymyxinstoxicity

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