title: Colistin resistance in Klebsiella pneumoniae.
abstract: Increasing use of colistin for multidrug-resistant Gram-negative bacterial infections has led to the emergence of colistin resistance in Klebsiella pneumoniae in several countries worldwide, including Europe (especially Greece), and colistin resistance rates are continually increasing. Heteroresistance rates, which were significantly higher than resistance rates, were found to be important. Although the mechanism underlying resistance is unclear, it has been suggested that it is related to lipopolysaccharide modification via diverse routes. Several factors have been reported as being associated with colistin resistance, with improper use and patient-to-patient transmission being most often cited. Total infections and infection-related mortality from colistin-resistant K. pneumoniae are high, but currently there are no established treatment regimens. However, several combination regimens that are mainly colistin-based have been found to be successful for treating such infections.
authors.affiliation: College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-no, Sangnok-gu, Ansan, Gyeonggi-do 462-791, South Korea.
authors.forename: Young-Mi
authors.initials: YM
authors.lastname: Ah
authors.affiliation: Department of Pharmacy, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, South Korea.
authors.forename: Ah-Jung
authors.initials: AJ
authors.lastname: Kim
authors.affiliation: College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-no, Sangnok-gu, Ansan, Gyeonggi-do 462-791, South Korea. Electronic address: jypharm@hanyang.ac.kr.
authors.forename: Ju-Yeun
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000502:physiology*; D004359:Drug Therapy, Combination; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000254:growth & development / Q000378:metabolism*; D008070:Lipopolysaccharides / Q000737:chemistry / Q000378:metabolism; D008826:Microbial Sensitivity Tests; D016896:Treatment Outcome; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D008070:Lipopolysaccharides; D001618:beta-Lactamases; D003091:Colistin
keywords: Colistin; Epidemiology; Klebsiella pneumoniae; Microbial resistance; Multidrug resistance