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Prevalence of polymyxin resistance through the food chain, the global crisis

Mousumi Ray1, Ashwini Manjunath2, Prakash M Halami3

  • 1Department of Microbiology and Fermentation Technology, CSIR- Central Food Technological Research Institute, Mysuru, 570020, India.

The Journal of Antibiotics
|January 26, 2022
PubMed

Insights

Antimicrobial resistance to last-resort antibiotics like colistin is a growing global health threat. This review examines polymyxin resistance mechanisms, gene variants, and transmission routes, emphasizing food safety and implications for India.

Area of Science:

  • Microbiology
  • Global Health
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) poses a critical global health challenge.
  • Multi-drug resistant (MDR) Gram-negative bacterial infections are increasingly treated with last-resort antibiotics, colistin (polymyxin E) and polymyxin B.
  • Inappropriate antibiotic use, particularly in agriculture, has driven resistance to these vital drugs.

Purpose of the Study:

  • To review current scientific literature on polymyxin resistance mechanisms.
  • To investigate gene variants, detection methods, and transmission pathways of polymyxin resistance.
  • To highlight the implications of polymyxin usage in India and propose future food safety strategies.

Main Methods:

  • Comprehensive literature review of scientific publications on polymyxin resistance.
  • Analysis of mechanisms including intrinsic, mutational, and genetic alterations.
  • Examination of the role of the mobile colistin/polymyxin B resistance (mcr) gene.

Main Results:

  • Polymyxin resistance mechanisms involve alterations in the lipopolysaccharide (LPS) lipid A moiety, reducing drug affinity.
  • The mobile colistin/polymyxin B resistance (mcr) gene facilitates horizontal resistance dissemination via the food chain.
  • Urgent need for enhanced surveillance of polymyxin resistance is identified.

Conclusions:

  • Understanding polymyxin resistance mechanisms and transmission is crucial for preserving antibiotic efficacy.
  • Food safety interventions and responsible antibiotic stewardship are essential to combat resistance.
  • Specific focus on polymyxin usage in India is needed to address regional challenges and ensure future drug availability.

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