Current and emerging polymyxin resistance diagnostics: A systematic review of established and novel detection methods

Leshaba, Tumisho Mmatumelo Seipei; Mbelle, Nontombi Marylucy; Sekyere, John Osei

doi:10.1111/jam.15184

Cited by 12 publications

(14 citation statements)

References 104 publications

(481 reference statements)

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“…Some of these tests (such as the BMD, ComASP™ Colistin, MicroScan, Sensititre and Vitek) are mainly MIC (minimum-inhibitory concentration)-based, measuring only the MICs of the isolates while others are non-MIC—based, purely providing a binary result of resistant or sensitive (such as the CHROMagar COL- APSE , and Rapid NP test) [10–12]. The Rapid NP test was designed to only detect colistin resistance in Enterobacterales and is therefore not useful for all Gram-negative bacteria [10,13]. As a follow-up to previous research [11], we used 142 Gram-negative isolates and controls to evaluate the performance of six colistin resistance diagnostic tests: ComASP Colistin, CHROMagar COL- APSE , Rapid NP test, Sensititre, Vitek 2, and the MicroScan.…”

Section: Introductionmentioning

confidence: 99%

“…As a follow-up to previous research [11], we used 142 Gram-negative isolates and controls to evaluate the performance of six colistin resistance diagnostic tests: ComASP Colistin, CHROMagar COL- APSE , Rapid NP test, Sensititre, Vitek 2, and the MicroScan. The BMD remains the gold standard for testing colistin MICs and resistance in bacteria [10]; hence it was used as the reference standard in these evaluation studies.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Six Commercial and Non-Commercial Colistin Resistance Diagnostics

Leshaba,

Mmatli,

Skosana

et al. 2024

Preprint

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Background. Resistance to colistin, a last-reserve antibiotic used for treating drug-resistant infections, is increasing globally. This study evaluated six diagnostic tests designed to detect colistin-resistant pathogens. Methods. PCR and broth microdilution assays (BMD) were used to respectively characterize the molecular mechanisms and phenotypic colistin resistance of 142 Gram-negative bacterial isolates and controls. The sensitivity, specificity, positive- and negative-predictive values, major (ME) and very major errors (VME), categorical and essential agreements (EA) of ComASP Colistin, CHROMagar COL-APSE, Rapid NP Test, Sensititre, MicroScan, and Vitek 2 were determined with these isolates; the BMD was used as gold standard. Results. The Vitek 2, Sensititre, and ComASP tests were more efficient, albeit with concerning ME and VMEs and low EAs. Sensititre was 100% specific with 0% ME and 3.61% VME; Vitek 2 had the least VME (1.25% and 0%) and a low EA (57.50%). ComASP had an EA of 75.35%. MicroScan was highly sensitive (96.55%) but less specific (87.50%), with very below-accetable EAs (48.11%). The CHROMAgar COL-APSE efficiently identified the species with their unique colours but was the least specific (67.80%), with the highest ME (32.20%) and high VME (7.23%). The Rapid NP test had the highest VME (7.84%), producing results within 4 hours with 92.16% sensitivity and 96.08% specificity. Conclusion: Vitek 2, MicroScan, ComASP colistin, and Sensititre are good for determining colistin resistance; the latter two tests are recommendable for low-resourced laboratories. The in-house Rapid NP test has short turnaround time with high efficiency for initial resistance screening.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Six Commercial and Non-Commercial Colistin Resistance Diagnostics

Leshaba,

Mmatli,

Skosana

et al. 2024

Preprint

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“…Unfortunately, the worrying emergence of the predominantly plasmid-borne colistin resistance gene mcr-1 , carbapenem resistance gene bla NDM-1 as well as tigecycline resistance gene tet(X4) in Enterobacteriaceae pathogens from different sources, such as animals, food and humans, has increasingly been reported in different continents ( Singh et al, 2018 ; Zhong et al, 2019 ; Anyanwu et al, 2022 ; Lu et al, 2022 ; Zhang et al, 2022 ). Additionally, tet(X) genes have regularly been reported to coexist with bla NDM-1 and/or mcr-1 genes ( Chen et al, 2019 ; Sun C. et al, 2019 ), and such plasmid-borne antibiotic resistance genes (ARGs) are capable of transferring between epidemic strains of Enterobacteriaceae ( Leshaba et al, 2022 ). Thus, a fast, efficient and accurate detection method for simultaneously screening and monitoring the above-mentioned ARGs in Enterobacteriaceae pathogens has become urgently needed for managing the dissemination of resistance in food animal and human populations throughout the food chain and relevant environments.…”

Section: Introductionmentioning

confidence: 99%

Rapid detection of multiple resistance genes to last-resort antibiotics in Enterobacteriaceae pathogens by recombinase polymerase amplification combined with lateral flow dipstick

Wang

Pan³

et al. 2023

Front. Microbiol.

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The worrying emergence of multiple resistance genes to last-resort antibiotics in food animals and human populations throughout the food chain and relevant environments has been increasingly reported worldwide. Enterobacteriaceae pathogens are considered the most common reservoirs of such antibiotic resistance genes (ARGs). Thus, a rapid, efficient and accurate detection method to simultaneously screen and monitor such ARGs in Enterobacteriaceae pathogens has become an urgent need. Our study developed a recombinase polymerase amplification (RPA) assay combined with a lateral flow dipstick (LFD) for simultaneously detecting predominant resistance genes to last-resort antibiotics of Enterobacteriaceae pathogens, including mcr-1, blaNDM-1 and tet(X4). It is allowed to complete the entire process, including crude DNA extraction, amplification as well as reading, within 40 min at 37°C, and the detection limit is 101 copies/μl for mcr-1, blaNDM-1 and tet(X4). Sensitivity analysis showed obvious association of color signals with the template concentrations of mcr-1, blaNDM-1 and tet(X4) genes in Enterobacteriaceae pathogens using a test strip reader (R2 = 0.9881, R2 = 0.9745, and R2 = 0.9807, respectively), allowing for quantitative detection using multiplex RPA-LFD assays. Therefore, the RPA-LFD assay can suitably help to detect multiple resistance genes to last-resort antibiotics in foodborne pathogens and has potential applications in the field.

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“…The mcr genes encode transmembrane enzymes, including phosphoethanolamine (pEtN) transferase, which mediates COL resistance by attaching a pEtN moiety to the lipopolysaccharide (LPS) of lipid A in the outer membrane of Gram-negative bacilli, thereby eliminating the negative charge on the LPS to which cationic COL/polymyxins have an affinity [ 20 ]. There has been extensive discourse on the methods used in the detection of these genes and their specific characteristics [ 14 , 21 , 22 , 23 , 24 , 25 ]. Although the transmission of chromosome-borne and non-conjugative plasmid-encoded mcr genes is clonally restricted [ 7 , 11 ], conjugative plasmid-borne mcr genes are rapidly transferred to other organisms (i.e., inter/intraspecies and genera transmission) as these plasmids are highly promiscuous, thus jeopardizing antimicrobial/COL therapy [ 7 , 11 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Traits of Mobile Colistin Resistance (mcr) Gene-Bearing Organisms from Horses

et al. 2022

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Mobile colistin resistance (mcr) genes (mcr-1 to mcr-10) threaten the efficacy of colistin (COL), a polymyxin antibiotic that is used as a last-line agent for the treatment of deadly infections caused by multidrug-resistant and extensively drug-resistant bacteria in humans and animals. COL has been used for more than 60 years for the prophylactic control and treatment of infections in livestock husbandry but not in horses. Polymyxin B is used for the prophylactic control and empirical treatment of infections in horses without conducting sensitivity tests. The lack of sensitivity testing exerts selection pressure for the acquisition of the mcr gene. By horizontal transfer, mcr-1, mcr-5, and mcr-9 have disseminated among horse populations globally and are harbored by Escherichia coli, Klebsiella, Enterobacter, Citrobacter, and Salmonella species. Conjugative plasmids, insertion sequences, and transposons are the backbone of mcr genes in the isolates, which co-express genes conferring multi- to extensive-drug resistance, including genes encoding extended-spectrum β-lactamase, ampicillinase C, fosfomycin, and fluoroquinolone resistance, and virulence genes. The transmission of mcr genes to/among bacterial strains of equine origin is non-clonal. Contact with horses, horse manure, feed/drinking water, farmers, farmers’ clothing/farm equipment, the consumption of contaminated horse meat and its associated products, and the trading of horses, horse meat, and their associated products are routes for the transmission of mcr-gene-bearing bacteria in, to, and from the equine industry.

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Current and emerging polymyxin resistance diagnostics: A systematic review of established and novel detection methods

Cited by 12 publications

References 104 publications

Evaluation of Six Commercial and Non-Commercial Colistin Resistance Diagnostics

Evaluation of Six Commercial and Non-Commercial Colistin Resistance Diagnostics

Rapid detection of multiple resistance genes to last-resort antibiotics in Enterobacteriaceae pathogens by recombinase polymerase amplification combined with lateral flow dipstick

Epidemiology and Traits of Mobile Colistin Resistance (mcr) Gene-Bearing Organisms from Horses

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