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 Table of Contents  
Year : 2020  |  Volume : 10  |  Issue : 1  |  Page : 1-2

Colistin resistance and rapid spread colistin resistance gene: A significant public health challenge worldwide

1 Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2 Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia

Date of Submission24-Aug-2019
Date of Acceptance09-Dec-2019
Date of Web Publication03-Jan-2020

Correspondence Address:
Mainul Haque
Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Perdana Sungai Besi, 57000 Kuala Lumpur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AIHB.AIHB_94_19

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How to cite this article:
Shampa SA, Haque M. Colistin resistance and rapid spread colistin resistance gene: A significant public health challenge worldwide. Adv Hum Biol 2020;10:1-2

How to cite this URL:
Shampa SA, Haque M. Colistin resistance and rapid spread colistin resistance gene: A significant public health challenge worldwide. Adv Hum Biol [serial online] 2020 [cited 2022 Dec 5];10:1-2. Available from: https://www.aihbonline.com/text.asp?2020/10/1/1/275088

Colistin, a peptide antibiotic, initially isolated in 1947 from a soil bacterium Paenibacillus polymyxa subsp., with substantial activity against Gram-negative microorganisms.[1] The uses of colistin were restricted worldwide by the 1970s due to its toxic potential.[2] Nevertheless, colistin is being considered as the last resort antibiotic for the infections caused by multidrug-resistant Gram-negative bacteria, including carbapenem-resistant Acinetobacter, Pseudomonas and carbapenem-resistant Enterobacteriaceae, the previous two decades.[3] Colistin is widely used in livestock for infective disorders.[4] The overall prevalence rate of resistance was low. However, there has been a remarkable increase in colistin-resistant strains in recent years.[5] Plasmid-mediated colistin resistance gene mcr1 was first reported in China in 2015. All earlier reported resistance was chromosomally mediated.[6] Multiple studies revealed that mcr1 gene rapidly spread among animals, travellers, trading food animals and human environment across the globe.[7],[8],[9] Subsequently, plasmid-mediated resistance genes mcr2mcr8 have been identified in various infections from humans and animals.[10] The resistant genes have been detected in several Enterobacteriaceae species – Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Shigella sonnei, Enterobacter spp., Citrobacter spp., Providencia rettgeri, etc., from environment, food, humans, livestock, companion animals, vegetables, etc.[11] Resistant colistin genes isolates were transmitted from animals to human.[12] The coexistence of mcr1 with other resistance genes indicates the horizontal transmission and high potential of spread.[13] One health concept recognises that human health is connected to animal health and the environment.[14] Thereafter, the data regarding the colistin resistance of both animals and humans should be integrally analysed to monitor the distribution of the resistance pattern.[15] Improving the biosafety, biosecurity and the diet of livestock significantly reduces the misuse of colistin. The last effective antimicrobial should only be utilised cautiously for absolute clinical necessity. The prudent use of colistin should be prompted. In addition, regulatory control measures need to implement both national and international level to minimise the overall consumption of antimicrobials and to safeguard the ultimate choice.

  References Top

Poirel L, Jayol A, Nordmann P. Polymyxins: Antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes. Clin Microbiol Rev 2017;30:557-96.  Back to cited text no. 1
Gurjar M. Colistin for lung infection: An update. J Intensive Care 2015;3:3.  Back to cited text no. 2
Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K, Rayner CR, et al. Colistin: The re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis 2006;6:589-601.  Back to cited text no. 3
Catry B, Cavaleri M, Baptiste K, Grave K, Grein K, Holm A, et al. Use of colistin-containing products within the European Union and European Economic Area (EU/EEA): Development of resistance in animals and possible impact on human and animal health. Int J Antimicrob Agents 2015;46:297-306.  Back to cited text no. 4
Hembach N, Schmid F, Alexander J, Hiller C, Rogall ET, Schwartz T. Occurrence of the mcr-1 colistin resistance gene and other clinically relevant antibiotic resistance genes in microbial populations at different municipal wastewater treatment plants in Germany. Front Microbiol 2017;8:1282.  Back to cited text no. 5
Biswas S, Brunel JM, Dubus JC, Reynaud-Gaubert M, Rolain JM. Colistin: An update on the antibiotic of the 21st century. Expert Rev Anti Infect Ther 2012;10:917-34.  Back to cited text no. 6
Partridge SR, Di Pilato V, Doi Y, Feldgarden M, Haft DH, Klimke W, et al. Proposal for assignment of allele numbers for mobile colistin resistance (mcr) genes. J Antimicrob Chemother 2018;73:2625-30.  Back to cited text no. 7
Wang R, van Dorp L, Shaw LP, Bradley P, Wang Q, Wang X, et al. The global distribution and spread of the mobilized colistin resistance gene mcr-1. Nat Commun 2018;9:1179.  Back to cited text no. 8
Kempf I, Jouy E, Chauvin C. Colistin use and colistin resistance in bacteria from animals. Int J Antimicrob Agents 2016;48:598-606.  Back to cited text no. 9
Wang X, Wang Y, Zhou Y, Wang Z, Wang Y, Zhang S, et al. Emergence of Colistin Resistance Gene mcr-8 and its variant in Raoultella ornithinolytica. Front Microbiol 2019;10:228.  Back to cited text no. 10
Bakthavatchalam YD, Pragasam AK, Biswas I, Veeraraghavan B. Polymyxin susceptibility testing, interpretative breakpoints and resistance mechanisms: An update. J Glob Antimicrob Resist 2018;12:124-36.  Back to cited text no. 11
Lima T, Domingues S, Da Silva GJ. Plasmid-mediated colistin resistance in Salmonella enterica: A review. Microorganisms 2019;7. pii:E55.  Back to cited text no. 12
Falgenhauer L, Waezsada SE, Yao Y, Imirzalioglu C, Käsbohrer A, Roesler U, et al. Colistin resistance gene mcr-1 in extended-spectrum β-lactamase-producing and carbapenemase-producing Gram-negative bacteria in Germany. Lancet Infect Dis 2016;16:282-3.  Back to cited text no. 13
Zhi C, Lv L, Yu LF, Doi Y, Liu JH. Dissemination of the mcr-1 colistin resistance gene. Lancet Infect Dis 2016;16:292-3.  Back to cited text no. 14
Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). One Health Basics. Centers for Disease Control and Prevention; 2018. Available from: https://www.cdc.gov/onehealth/basics/index.html. [Last accessed on 2019 Aug 24].  Back to cited text no. 15

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