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Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Rebeca Siqueira Rubens1, Isabel de Souza Andrade Arruda1, Rosane Mansan Almeida1

  • 1Laboratório de Microbiologia e Imunologia Clínica (LabMIC), Departamento de Farmácia, Faculdade de Ciências da Saúde, Universidade de Brasília (UnB), Brasília 70910-900, DF, Brazil.

Microorganisms
|January 23, 2024
PubMed

Insights

Antimicrobial resistance is a major global health threat. This review examines laboratory methods for detecting polymyxin resistance, a critical challenge in treating multidrug-resistant bacterial infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Antimicrobial resistance (AMR) poses a significant global health threat, leading to increased mortality worldwide.
  • Polymyxins are essential last-resort antibiotics for treating infections caused by multidrug-resistant bacteria.
  • The standard broth microdilution method for polymyxin susceptibility testing is complex and challenging for routine laboratory use.

Purpose of the Study:

  • To review and discuss various laboratory methodologies for detecting polymyxin resistance.
  • To elucidate the challenges and future perspectives associated with these diagnostic methods.
  • To identify promising alternatives to the standard broth microdilution method for routine diagnostics.

Main Methods:

  • Review of existing literature on phenotypic and molecular methods for polymyxin resistance detection.
  • Discussion of methods including broth microdilution, commercial tests, rapid polymyxin NP test, polymyxin elution test, culture media, Polymyxin Drop Test, Sensititre®, molecular tests, MALDI-TOF MS, and Raman spectroscopy.
  • Analysis of the practicality, ease of use, and equipment requirements for each method in a laboratory setting.

Main Results:

  • Several phenotypic methods show promise for routine diagnostics, requiring accessible materials and simple procedures.
  • Advanced techniques like Sensititre®, molecular tests, MALDI-TOF MS, and Raman spectroscopy offer reliable results but require specialized equipment not widely available.
  • Each method presents unique advantages and limitations regarding cost, speed, and accessibility.

Conclusions:

  • There is a need for accessible and reliable laboratory methods to detect polymyxin resistance in routine diagnostics.
  • Balancing accuracy, cost, and ease of implementation is crucial for adopting new polymyxin resistance detection methods.
  • Further development and validation of user-friendly techniques are essential to combat the growing threat of multidrug-resistant infections.
Keywords:
Gram-negative bacteriaantimicrobial susceptibilitypolymyxin resistancepolymyxins

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