Resistance to polymyxins in Gram-negative organisms.
Polymyxins have recently been re-introduced into the therapeutic arsenal to combat infections caused by multidrug-resistant Gram-negative bacteria. However, the emergence of strains resistant to these last-resort drugs is becoming a critical issue in a growing number of countries. Both intrinsic and transferable mechanisms of polymyxin resistance have been characterised. These mechanisms as well as the epidemiological data regarding four relevant bacterial pathogens (Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa) are considered in this review. A special focus is made on plasmid-mediated resistance and the spread of mcr genes.
Laboratoire de bactériologie, Centre national de référence (CNR) de la résistance aux antibiotiques, Centre hospitalier universitaire (CHRU) de Besançon, boulevard Fleming, 25000 Besançon, France. Electronic address: katy.jeannot@univ-fcomte.fr.
Katy
K
Jeannot
Laboratoire de bactériologie, Centre national de référence (CNR) de la résistance aux antibiotiques, Centre hospitalier universitaire (CHRU) de Besançon, boulevard Fleming, 25000 Besançon, France.
Arnaud
A
Bolard
Laboratoire de bactériologie, Centre national de référence (CNR) de la résistance aux antibiotiques, Centre hospitalier universitaire (CHRU) de Besançon, boulevard Fleming, 25000 Besançon, France.
Patrick
P
Plésiat
D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics; D029968:Escherichia coli Proteins / Q000235:genetics; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000235:genetics; D010957:Plasmids / Q000235:genetics; D011113:Polymyxins / Q000494:pharmacology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000235:genetics
D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; C000614037:MCR-1 protein, E coli; D011113:Polymyxins
Acinetobacter baumannii; Colistin resistance; Enterobacteriaceae; MCR-1; Pseudomonas aeruginosa; Two-components systems