title: MCR: modern colistin resistance.
abstract: Recently, plasmid-mediated and, therefore, transferable bacterial polymyxin resistance was discovered in strains from both humans and animals. Such a trait may widely spread geographically, while simultaneously crossing microbial species barriers. This may ultimately render the "last resort" polymyxin antibiotics therapeutically useless. Colistin is currently used to treat infections caused by Gram-negative carbapenemase producers and colistin resistance may lead to practical pan-antibiotic resistance. We here analyzed the medical and diagnostic consequences of (emerging) colistin resistance and propose pathways toward adequate diagnostics for timely detection of both asymptomatic carriage and infection. Culture-based testing using chromogenic and selective media for screening clinical (and veterinary) specimens may constitute key tools for that purpose. Relevant molecular tests are also discussed.
authors.affiliation: Medical Affairs, bioMérieux SA, 376, Chemin de l'Orme, 69280, Marcy L'Etoile, France.
authors.forename: I
authors.initials: I
authors.lastname: Caniaux
authors.affiliation: Scientific Office, bioMérieux SA, 3, Route de Port Michaud, 38390, La Balme-les-Grottes, France.
authors.forename: A
authors.initials: A
authors.lastname: van Belkum
authors.affiliation: Scientific Office, bioMérieux SA, 3, Route de Port Michaud, 38390, La Balme-les-Grottes, France.
authors.forename: G
authors.initials: G
authors.lastname: Zambardi
authors.affiliation: Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Rue Albert Gockel 3, 1700, Fribourg, Switzerland.|INSERM European Unit (LEA, IAME, France), University of Fribourg, Fribourg, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Poirel
authors.affiliation: Medical Affairs, bioMérieux SA, 376, Chemin de l'Orme, 69280, Marcy L'Etoile, France. marie-francoise.gros@biomerieux.com.
authors.forename: M F
authors.initials: MF
authors.lastname: Gros
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002353:Carrier State / Q000175:diagnosis / Q000382:microbiology / Q000662:veterinary; D003091:Colistin / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D022761:Gene Transfer, Horizontal; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology* / Q000662:veterinary; D006801:Humans; D010957:Plasmids
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin