An overview of colistin resistance: A breach in last line defense

Rout, Bidyut Prava; Behera, Birasen; Sahu, Kundan Kumar; Praharaj, Ira; Otta, Sarita

doi:10.1016/j.mjafi.2023.06.006

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…Plasmid mediated ( mcr ) colistin resistance was first detected in 2015 in food industries in China and since then has been reported in various other countries [ 35 ]. But in our study no mcr 1–5 mediated resistance was detected similar to other studies from India [ 1, 36 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Rout,

Dash,

Sahu

et al. 2023

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Introduction. The increasing antibiotic resistance like the advent of carbapenem resistant Enterobactarales (CRE), Carbapenem Resistant Acinetobacter baumanii (CRAB), and Carbapenem Resistant Pseudomonas aeruginosa (CRPA) has led to to the use of toxic and older drugs like colistin for these organisms. But worldwide there is an increase in resistance even to colistin mediated both by chromosomes and plasmids. This necessitates accurate detection of resistance. This is impeded by the unavailability of a user-friendly phenotypic methods for use in routine clinical microbiology practice. The present study attempts to evaluate two different methods – colistin broth disc elution and MIC detection by Vitek two in comparison to CLSI approved broth microdilution (BMD) for colistin for Enterobactarales, Pseudomonas aeruginosa , and Acinetobacter baumanii clinical isolates. Methods. Colistin susceptibility of 6013 carbapenem resistant isolates was determined by BMD, Colistin Broth Disc Elution (CBDE), and Vitek two methods and was interpreted as per CLSI guidelines. The MIC results of CBDE, Vitek two were compared with that of BMD and essential agreement (EA), categorical agreement (CA), sensitivity, specificity, very major error (VME), major error (ME) and Cohen’s kappa (CK) was calculated. The presence of any plasmid-mediated colistin resistance (mcr-1, 2, 3, 4 and 5) was evaluated in all colistin-resistant isolates by conventional polymerase chain reaction. Results. Colistin resistance was found in 778 (12.9 %) strains among the carbapenem resistant isolates. Klebsiella pneumoniae had the highest (18.9 %) colistin resistance by the BMD method. MIC of Vitek two had sensitivity ranging from 78.2–84.8% and specificity of >92 %. There were 171 VMEs and 323 MEs by Vitek two method, much more than CLSI acceptable range. The highest percentage of errors was committed for Acinetobacter baumanii (27.8 % of VME and 7.9 % ME). On the other hand, the CBDE method performed well with EA, CA, VME and ME within acceptable range for all the organisms. The sensitivity of the CBDE method compared to gold standard BMD varied from 97.5–98.8 % for different strains with a specificity of more than 97.6 %. None of the isolated colistin resistant organisms harboured mcr plasmids. Conclusion. As BMD has many technical complexities, CBDE is the best viable alternative available for countries like India. A sensitive MIC reported by Vitek two needs to be carefully considered due high propensity for VMEs particularly for Klebsiella spp.

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Section: Discussionmentioning

confidence: 99%

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Rout,

Dash,

Sahu

et al. 2023

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Escherichia coli y Salmonella spp. portadoras de mcr-1 en planta de beneficio porcino, Medellín (Colombia)

Palacio-Arias,

Cienfuegos-Gallet,

Fernández-Silva

et al. 2023

Rev MVZ Córdoba

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Objective. This study aimed to evaluate the acquired mcr-1 gene-mediated colistin resistance in Escherichia coli and Salmonella spp. isolates obtained from fecal samples in pigs destined for human consumption at slaughterhouse located in Medellín (Colombia). Materials and methods. A descriptive study was carried out, in which 190 fecal samples were collected from pigs at the slaughterhouse in March 2020. Colistin sulfate-supplemented chromogenic and MacConkey agars were used for the screening of colistin-resistant enterobacteria. The selected isolates were analyzed by PCR to identify the presence of the mcr-1 gene. Bacterial identification and antibiotic susceptibility profile were performed on mcr-1 gene-positive isolates by the automated Microscan® system. The information was collected and analyzed using descriptive statistics. Results. The 70.52% (134/190) of the animals were positive for colistin-resistant isolates by the screening test. The 15.78% (30/190) of the isolates were mcr-1 gene carriers, of which 1.05% (2/190) belong to Salmonella enterica species and 4.21% (8/190) were E. coli. A multiple antibiotics resistance profile (10/10) and an extended-spectrum beta-lactamase (ESBL) -producing E. coli were identified in all the isolates carrying the mcr-1 gene. Most of the pigs with enterobacteria carrying the mcr-1 gene came from farms located in the province of Antioquia, and all belonged to the growing-finishing production stage. Conclusions. This study evidences the circulation of the mcr-1 type gene in pigs at the time of slaughter, representing a potentially serious threat to public health due to possible implications in the food chain.

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An overview of colistin resistance: A breach in last line defense

Cited by 2 publications

References 39 publications

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Escherichia coli y Salmonella spp. portadoras de mcr-1 en planta de beneficio porcino, Medellín (Colombia)

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