Colistin resistance among Gram-negative isolates in Nepal: A review

Abstract

<jats:p>Background: Colistin resistance among Gram-negative isolates is a tremendous public health problem, and there are very few studies in Nepal about these pathogens. Hence, this review provides comprehensive data on colistin resistance among Gram-negative isolates from various samples in Nepal.&#x0D; Methods: Articles reporting colistin resistance among various Gram-negative isolates from Nepal before July 2019 were selected; analyzed and relevant data was collected.&#x0D; Results: Colistin resistance was low among clinical isolates (less than 6%) in comparison to food and animal isolates (up to 69%). A wide variety of clinical isolates were colistin-resistant in comparison to food and animal isolates. Many of these isolates were highly drug-resistant and also harbored various drug-resistant determinants.&#x0D; Conclusion: Increased colistin resistance among Gram-negative pathogens is a serious concern. Screening of these isolates in clinical settings, animal farms, and food industries, as well as cautious use of colistin in both clinical and animal farms, is imminent.</jats:p>

Emergence of Nosocomial Pneumonia Caused by Colistin-Resistant Escherichia coli in Patients Admitted to Chest Intensive Care Unit

“…A similar high level of colistin resistance (23.1%) was observed in the same hospital among E. coli isolated from urine samples [50]. Overall, the rate of colistin resistance was higher when compared with other reported cases in other countries [51][52][53]. A study from the worldwide SEN-TRY antimicrobial surveillance program reported that resistance to polymyxins is stable for most Gram-negative pathogens except for Klebsiella species.…”

Detection of blaNDM−1,mcr-1 and MexB in multidrug resistant Pseudomonas aeruginosa isolated from clinical specimens in a tertiary care hospital of Nepal

“…colistin are now used as a last line drugs to treat such emerging pathogens [ 2 , 5 ]. However, colistin resistant P. aeruginosa is also being reported recently that is in increasing trend globally [ 6 ]. Similarly, in P. aeruginosa along with carbapenem and colistin resistant genes, overexpression of efflux pump is also one of the intrinsic mechanism that is serving them to develop into superbugs.…”

“…Among them most common type in P. aeruginosa is NDM type; as it is located in plasmid and have a high global dissemination rate [ 8 , 9 ]. Likewise, in Nepal, the prevalence of colistin resistant P. aeruginosa has increased to 2.8% [ 6 ]. Resistance to colistin in bacterial species can be either intrinsic type or acquired via chromosomal mutation or genes carried on plasmid [ 10 ].…”

Multi-drug Resistance, β-Lactamases Production, and Coexistence of blaNDM-1 and mcr-1 in Escherichia coli Clinical Isolates From a Referral Hospital in Kathmandu, Nepal

“…Only about one-fourth of the total samples showed bacterial growth positivity. The common isolates were Gram-negative because the infection caused by the group is predominant in hospital settings 35 , 36 and their persistence in community settings is also reported. 37 The majority of them were E. coli (n = 77) since the organism is frequently associated with nosocomial and community-acquired infections.…”

“…The incidence of colistin resistance exhibited by E. coli from food-producing animals in Nepal is a major concern. 15 , 35 This indicates a high possibility of zoonotic transmission of this resistance to humans resulting in increased prevalence in clinical isolates. 52 , 53 In our experiments, the MIC value of colistin was demonstrated up to 16 g/L.…”