title: Emergence of colistin-resistant bacteria in humans without colistin usage: a new worry and cause for vigilance.
abstract: Colistin is currently regarded as one of the 'last-resort' antibiotics used for the treatment of critical infections caused by multidrug-resistant Gram-negative pathogens. There have been numerous reports of the emergence of colistin resistance in patients, most of whom had previously received colistin therapy or with acquisition via nosocomial transmission. However, there are also ample reports of colistin resistance in humans who have not received the drug previously or without nosocomial transmission. We have also observed a similar occurrence in our study involving colistin resistance from several countries along with a similar phenomenon being reported by researchers. The observation of colistin resistance in humans without prior colistin exposure is of particularly great clinical importance and concern because of the current importance of colistin in clinical medicine. Colistin use and colistin-resistant bacteria in animals have been recently reported, suggesting that animals could also be a source of transmission of colistin-resistant bacteria to humans. This is a real worry and calls for clinicians to be aware and vigilant of this phenomenon and of the possibility of independent resistance to colistin in some patients.
authors.affiliation: Aix-Marseille Université, URMITE, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France.
authors.forename: Abiola Olumuyiwa
authors.initials: AO
authors.lastname: Olaitan
authors.affiliation: Institut des Sciences de l'Évolution, CNRS-IRD-UM2, CC065, Université Montpellier 2, 34095 Montpellier Cedex 05, France; CNRS-CIRAD, Centre d'Infectiologie Christophe Mérieux du Laos, Vientiane, Lao Democratic People's Republic.
authors.forename: Serge
authors.initials: S
authors.lastname: Morand
authors.affiliation: Aix-Marseille Université, URMITE, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France. Electronic address: jean-marc.rolain@univ-amu.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission / Q000662:veterinary; D006801:Humans; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin
keywords: Cationic antimicrobial peptides; Enterobacteriaceae; Veterinary