scholarly journals Prevalence of Acquired Colistin Resistance among Gram Negative Bacilli Isolated from Patients Admitted at Cairo University Hospitals

2022 ◽  
Vol 31 (1) ◽  
pp. 97-104
Author(s):  
Ashraf Sorour ◽  
Karim Ibrahim ◽  
Asmaa Hegab
Keyword(s):  
Colistin Resistance ◽  
University Hospitals ◽  
Gram Negative

Prevalence of Colistin resistance among Enterobacteriaceae, A 10-year glance

2021 ◽  
Vol 1 (1) ◽  
pp. 016-024
Author(s):  
Assama Riaz ◽  
Dinali Obeysekera ◽  
Kelsie Ruslow
Keyword(s):  
Healthcare Systems ◽  
Klebsiella Pneumonia ◽  
Unanswered Question ◽  
Colistin Resistance ◽  
Klebsiella Species ◽  
Gram Negative ◽  
The World ◽  
Gram Negative Organisms ◽  
Almost All ◽  
Alternative Antibiotic

Multidrug resistance is a global healthcare problem. Gram-negative organisms, particularly Enterobacteriaceae strains are responsible for almost 60% of nosocomial infections. Colistin acts as the last treatment resort in complicated, critical, and MDR cases; also become resistant in the last few years in an escalating manner. Its resistance has been reported almost all over the world. Since there is no alternative antibiotic of colistin-resistant isolates is available. The last year of 2020 was completely engaged with the Covid-19 pandemic for global healthcare systems. This issue is still persisting with no solution. Strict infection control policies and a noval antibiotic with lesser side effects are great in demand to resolve this issue. We gathered 28 studies from 2010 that reported colistin resistance among Enterobacteriaceae throughout the world. Colistin resistance still reported and escalated globally with no available solution. Asia was the leading region with 50% of selected studies followed by Europe and Klebsiella pneumonia and Klebsiella species were the leading organisms of colistin resistance among Enterobacteriaceae. This mini-review was designed to highlight the global importance of colistin-resistant isolates among Enterobacteriaceae, which still an unanswered question.

scholarly journals Comparison of the Superpolymyxin and ChromID Colistin R Screening Media for the Detection of Colistin-Resistant Enterobacteriaceae from Spiked Rectal Swabs

2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Delphine Girlich ◽  
Thierry Naas ◽  
Laurent Dortet
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Confidence Interval ◽  
Enterobacter Cloacae ◽  
Bacterial Isolates ◽  
Colistin Resistance ◽  
Gram Negative ◽  
Content Type ◽  
Rectal Swabs ◽  
Stool Samples

ABSTRACT The dissemination of carbapenemase-producing Enterobacteriaceae (CPE) has led to the increased use of colistin, which has resulted in the emergence of colistin-resistant Enterobacteriaceae worldwide. One of the most threatening scenarios is the dissemination of colistin resistance in CPE, particularly the plasmid-encoded resistance element MCR. Thus, it has now become mandatory to possess reliable media to screen for colistin-resistant Gram-negative bacterial isolates, especially Enterobacteriaceae. In this study, we evaluated the performances of the Superpolymyxin medium (ELITechGroup) and the ChromID Colistin R medium (bioMérieux) to screen for colistin-resistant Enterobacteriaceae from spiked rectal swabs. Stool samples were spiked with a total of 94 enterobacterial isolates (Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Enterobacter cloacae), including 53 colistin-resistant isolates. ESwabs (Copan Diagnostics) were then inoculated with those spiked fecal suspensions, and culture proceeded as recommended by both manufacturers. The sensitivity of detection of colistin-resistant Enterobacteriaceae was 86.8% (95% confidence interval [95% CI] = 74.0% to 94.0%) using both the Superpolymyxin medium and the ChromID Colistin R plates. Surprisingly, the isolates that were not detected were not the same for both media. The specificities were high for both media, at 97.9% (95% CI = 87.3% to 99.9%) for the Superpolymyxin medium and 100% (95% CI = 90.4% to 100%) for the ChromID Colistin R medium. Both commercially available media, ChromID Colistin R and Superpolymyxin, provide useful tools to screen for colistin-resistant Enterobacteriaceae from patient samples (rectal swabs) regardless of the level and mechanism of colistin resistance.

scholarly journals NMPA-approved traditional Chinese medicine-Pingwei Pill: new indication for colistin recovery against MCR-positive bacteria infection

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qiushuang Sheng ◽  
Runbao Du ◽  
Cunhui Ma ◽  
Yonglin Zhou ◽  
Xue Shen ◽  
...  
Keyword(s):  
Molecular Docking ◽  
Bacterial Infection ◽  
Molecular Mechanisms ◽  
Topological Analysis ◽  
Network Pharmacology ◽  
Synergistic Activity ◽  
Colistin Resistance ◽  
Western Blot Assay ◽  
Gram Negative

Abstract Background The wide spread of plasmid-mediated colistin resistance by mobile colistin resistance (MCR) in Enterobacteriaceae severely limits the clinical application of colistin as a last-line drug against bacterial infection. The identification of colistin potentiator from natural plants or their compound preparation as antibiotic adjuncts is a new promising strategy to meet this challenge. Methods Herein, the synergistic activity, as well as the potential mechanism, of Pingwei pill plus antibiotics against MCR-positive Gram-negative pathogens was examined using checkerboard assay, time-killing curves, combined disk test, western blot assay, and microscope analysis. Additionally, the Salmonella sp. HYM2 infection models of mouse and chick were employed to examine the in vivo efficacy of Pingwei pill in combination with colistin against bacteria infection. Finally, network pharmacology and molecular docking assay were used to predicate other actions of Pingwei pill for Salmonella infection. Results Our results revealed that Pingwei Pill synergistically potentiated the antibacterial activity of colistin against MCR-1-positive bacteria by accelerating the damage and permeability of the bacterial outer membrane with an FIC (Fractional Inhibitory Concentration) index less than 0.5. The treatment of Pingwei Pill neither inhibited bacterial growth nor affected MCR production. Notably, Pingwei Pill in combination with colistin significantly prolonged the median survival in mouse and chick models of infection using the Salmonella sp. strain HYM2, decreased bacteria burden and organ index of infected animal, alleviated pathological damage of cecum, which suggest that Pingwei Pill recovered the therapeutic performance of colistin for MCR-1- positive Salmonella infection in mice and the naturally infected host chick. Pharmacological network topological analysis, molecular docking, bacterial adhesion, and invasion pathway verification assays were performed to identify the other molecular mechanisms of Pingwei Pill as a colistin potentiator against Gram-negative bacteria infection. Conclusion Taken together, NMPA (National Medical Products Administration)-approved Pingwei Pill is a promising adjuvant with colistin for MCR-positive bacterial infection with a shortened R&D (research and development) cycle and affordable R&D cost and risk.

scholarly journals Formation in vitro of colistin resistance in carbapenem-resistant Gram-negative bacteria and its biological cost

2021 ◽  
Author(s):  
D. V. Tapalski ◽  
T. A. Petrovskaya ◽  
A. E. Kozlov
Keyword(s):  
Broth Culture ◽  
Exponential Growth Phase ◽  
Lag Phase ◽  
Gram Negative Bacteria ◽  
Colistin Resistance ◽  
Gram Negative ◽  
Broth Microdilution Method ◽  
Resistant Mutants ◽  
Biological Cost

Introduction. The spread of resistance to carbapenems among gram-negative bacteria have led to an increase in the consumption of polymyxins and the emergence of certain strains resistant to them. Polymyxin resistance is mainly associated with mutations in chromosomal genes. The development of mutational resistance to antibiotics can lead to a decrease in the viability of bacteria, which is manifested by an increase in the duration of the cell cycle, a decrease in virulence and competitive fitness. The purpose of the study was to assess in vitro the intensity of the formation of colistin resistance in carbapenemresistant clinical isolates of gram-negative bacteria, the stability of the formed emerged resistance and its biological cost.Materials and methods. For 46 strains of Klebsiella pneumoniae, 77 strains of Pseudomonas aeruginosa and 42 strains of Acinetobacter baumannii, real time polymerase chain reaction (PCR) was used to detect the genes of carbapenemases, the minimum inhibitory concentrations (MIC) of meropenem and colistin were determined by broth microdilution method. The selection of resistant subpopulations on Muller–Hinton agar with the addition of 16 mg/l colistin was carried out. For colistin-resistant mutants and their isogenic sensitive strains, the kinetic parameters of growth in broth culture were determined. Incubation and result recording were performed on an Infinite M200 microplate reader for 18.5 hours at 35°C with measurement of light scatter in the wells every 15 minutes.Results. The production of carbapenemases MBL VIM in P. aeruginosa, MBL NDM, KPC and OXA-48 in K. pneumoniae, OXA-23 and OXA-40 in A. baumannii was observed. All strains were sensitive to colistin (MIC varied from 0.062 to 2 mg/l). The colony growth on a selective medium with16 mg/l colistin was observed for 97.8% of K. pneumoniae strains, 16.9% of P. aeruginosa strains, and 61.9% of A. baumannii strains. The mutational nature of colistin resistance was confirmed for 21.7% of K. pneumoniae strains. For colistin-resistant mutants of K. pneumoniae, a significant increase in the duration of the lag phase (Tlag) was observed: 225.6 ± 7.037 min in the wild-type susceptible strains and 245.5 ± 8.726 in resistant mutants, p = 0.037. The indicators of the doubling time of the number of microbial cells in the exponential growth phase (Tdoubling) and the area under the bacterial growth curve did not differ significantly.Conclusion. A high frequency of formation of colistin resistance in vitro in carbapenemase-producing strains of K. pneumoniae was observed. The absence of significant changes in the kinetics of microbial growth in resistant strains makes it possible to predict the further spread of mutational resistance to colistin, as well as its preservation in microbial populations of K. pneumoniae even in the case of limiting the use of this antibiotic. 

scholarly journals Colistin resistance among Gram-negative isolates in Nepal: A review

2020 ◽  
Vol 7 (1) ◽  
pp. 33-39
Author(s):  
Surya Prasad Devkota ◽  
Ashmita Paudel
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Clinical Isolates ◽  
Clinical Settings ◽  
Drug Resistant ◽  
Colistin Resistance ◽  
Gram Negative ◽  
Food Industries ◽  
Animal Farms ◽  
Animal Isolates

Background: Colistin resistance among Gram-negative isolates is a tremendous public health problem, and there are very few studies in Nepal about these pathogens. Hence, this review provides comprehensive data on colistin resistance among Gram-negative isolates from various samples in Nepal. Methods: Articles reporting colistin resistance among various Gram-negative isolates from Nepal before July 2019 were selected; analyzed and relevant data was collected. Results: Colistin resistance was low among clinical isolates (less than 6%) in comparison to food and animal isolates (up to 69%). A wide variety of clinical isolates were colistin-resistant in comparison to food and animal isolates. Many of these isolates were highly drug-resistant and also harbored various drug-resistant determinants. Conclusion: Increased colistin resistance among Gram-negative pathogens is a serious concern. Screening of these isolates in clinical settings, animal farms, and food industries, as well as cautious use of colistin in both clinical and animal farms, is imminent.

scholarly journals Emergence of Colistin Resistant Gram-Negative Bacteria in a Tertiary Care Rural Hospital in 2019

KYAMC Journal ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 87-90
Author(s):  
Abdullah Akhtar Ahmed ◽  
Nusrat Akhtar Juyee ◽  
SM Ali Hasan
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Salmonella Typhi ◽  
Rural Hospital ◽  
Gram Negative Bacteria ◽  
Bacterial Isolates ◽  
Colistin Resistance ◽  
Sensitivity Testing ◽  
Gram Negative

Background: Colistin-resistant Gram-negative bacteria is a rapidly emerging global threatgenerated a sense of public alarm. Objective: To combat this challenge a study was designedto evaluate the fast spreading infections by colistin-resistant pathogens in the tertiary care rural hospital of Bangladesh. Materials and Methods: To study isolation ofpathogenic gram-negative bacilli,clinical sample (n-640) of hospitalized patients of Khwaja Yunus Ali Medical College Hospital in Enayetpur, Bangladesh during the 1st quarter of the year 2019 were used. The bacterial isolates were screened for meropenem and colistin-resistance. Results: A total of 156 bacterial isolates were studied which included Escherichia coli (n-112), Klebsiella pneumoniae (n-14), Pseudomonas aeruginosa (n-27), and Salmonella typhi (n-3). Antibiotic sensitivity testing showed that 32/156(20%) and 119/156 (76%) isolates were resistant to meropenem and colistin, respectively. whereas 50/156 (32%) isolates were resistant to both antibiotics. Escherichia coli, K. pneumoniae, pseudomonas aeruginosa, and Salmonella typhi isolates respectivelywere 112/156 (72%), 14/156 (9%). 27/156 (17%), and 3/156 (2%). Conclusion: Colistin is typically used as salvage therapy, or last-line treatment, for MDR gramnegative infections.But there is worrisome therapeutic scenario in our study finding of colistin resistance is 76% in Gram-negative bacteria of the clinical isolates. The restricted and rational use of colistin drug is the need of hour. KYAMC Journal Vol. 11, No.-2, July 2020, Page 87-90

scholarly journals Diversified mcr-1 -Harbouring Plasmid Reservoirs Confer Resistance to Colistin in Human Gut Microbiota

mBio ◽  
2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Huiyan Ye ◽  
Yihui Li ◽  
Zhencui Li ◽  
Rongsui Gao ◽  
Han Zhang ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Colistin Resistance ◽  
Human Gut ◽  
Gram Negative ◽  
Sequence Mapping ◽  
Human Gut Microbiota ◽  
Functional Analyses ◽  
Conventional Idea

ABSTRACT Colistin is an ultimate line of refuge against multidrug-resistant Gram-negative pathogens. Very recently, the emergence of plasmid-mediated mcr-1 colistin resistance has become a great challenge to global public health, raising the possibility that dissemination of the mcr-1 gene is underestimated and diversified. Here, we report three cases of plasmid-carried MCR-1 colistin resistance in isolates from gut microbiota of diarrhea patients. Structural and functional analyses determined that the colistin resistance is conferred purely by the single mcr-1 gene. Genetic and sequence mapping revealed that mcr-1 -harbouring plasmid reservoirs are present in diversity. Together, the data represent the first evidence of diversity in mcr-1 -harbouring plasmid reservoirs of human gut microbiota. IMPORTANCE The plasmid-mediated mobile colistin resistance gene ( mcr-1 ) challenged greatly the conventional idea mentioned above that colistin is an ultimate line of refuge against lethal infections by multidrug-resistant Gram-negative pathogens. It is a possibility that diversified dissemination of the mcr-1 gene might be greatly underestimated. We report three cases of plasmid-carried MCR-1 colistin resistance in isolates from gut microbiota of diarrhea patients and functionally define the colistin resistance conferred purely by the single mcr-1 gene. Genetic and sequence mapping revealed unexpected diversity among the mcr-1 -harbouring plasmid reservoirs of human gut microbiota.

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