title: Resistance to colistin: what is the fate for this antibiotic in pig production?
abstract: Colistin, a cationic polypeptide antibiotic, has reappeared in human medicine as a last-line treatment option for multidrug-resistant Gram-negative bacteria (MDR-GNB). Colistin is widely used in veterinary medicine for the treatment of gastrointestinal infections caused by Enterobacteriaceae. GNB resistant to colistin owing to chromosomal mutations have already been reported both in human and veterinary medicine, however several recent studies have just identified a plasmid-mediated mcr-1 gene encoding for colistin resistance in Escherichia coli colistin resistance. The discovery of a non-chromosomal mechanism of colistin resistance in E. coli has led to strong reactions in the scientific community and to concern among physicians and veterinarians. Colistin use in food animals and particularly in pig production has been singled out as responsible for the emergence of colistin resistance. The present review will focus mainly on the possible link between colistin use in pigs and the spread of colistin resistance in Enterobacteriaceae. First we demonstrate a possible link between Enterobacteriaceae resistance emergence and oral colistin pharmacokinetics/pharmacodynamics and its administration modalities in pigs. We then discuss the potential impact of colistin use in pigs on public health with respect to resistance. We believe that colistin use in pig production should be re-evaluated and its dosing and usage optimised. Moreover, the search for competitive alternatives to using colistin with swine is of paramount importance to preserve the effectiveness of this antibiotic for the treatment of MDR-GNB infections in human medicine.
authors.affiliation: Chaire de recherche en salubrité des viandes (CRSV), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada; Groupe de recherche et d'enseignement en salubrité alimentaire (GRESA), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada; Centre de recherche en infectiologie porcine et avicole (CRIPA), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rhouma
authors.affiliation: Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.
authors.forename: Francis
authors.initials: F
authors.lastname: Beaudry
authors.affiliation: Chaire de recherche en salubrité des viandes (CRSV), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada; Groupe de recherche et d'enseignement en salubrité alimentaire (GRESA), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada; Centre de recherche en infectiologie porcine et avicole (CRIPA), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada; Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. Electronic address: ann.letellier@umontreal.ca.
authors.forename: Ann
authors.initials: A
authors.lastname: Letellier
mesh_terms: D000822:Animal Husbandry / Q000379:methods*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005075:Biological Evolution; D003091:Colistin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000662:veterinary*; D022761:Gene Transfer, Horizontal; D006801:Humans; D012641:Selection, Genetic; D013552:Swine
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin
keywords: Colistin; Escherichia coli; Human; Pharmacokinetic; Pigs; Resistance