2016
DOI: 10.1007/s10096-016-2846-y
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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 Blast 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 panantibiotic resistance. We here a… Show more

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Cited by 80 publications
(72 citation statements)
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“…This document highlights different actions for the implementation of surveillance strategies and antimicrobial stewardship about this topic. Moreover, the development of improved laboratory methods for the determination of the correct colistin MIC and molecular mcr-1 detection is considered beneficial and necessary (21). For colistin, a reliable evaluation of MICs, together with the possibility of therapeutic drug monitoring (TDM), is also necessary for the correct management of patients, given colistin's potential significant adverse effects, in order to avoid toxic effects while maintaining sufficient antibacterial activity (21).…”
Section: Resultsmentioning
confidence: 99%
“…This document highlights different actions for the implementation of surveillance strategies and antimicrobial stewardship about this topic. Moreover, the development of improved laboratory methods for the determination of the correct colistin MIC and molecular mcr-1 detection is considered beneficial and necessary (21). For colistin, a reliable evaluation of MICs, together with the possibility of therapeutic drug monitoring (TDM), is also necessary for the correct management of patients, given colistin's potential significant adverse effects, in order to avoid toxic effects while maintaining sufficient antibacterial activity (21).…”
Section: Resultsmentioning
confidence: 99%
“…Fortunately, isolate KP1749 retained susceptibility to multiple β-lactam agents, thus allowing adequate treatment and a satisfactory outcome. Since the description of mcr-1 , several other transferable mechanisms of colistin resistance have been identified [2]. Therefore, we need to develop more active surveillance approaches for detecting resistance to colistin.…”
Section: Discussionmentioning
confidence: 99%
“…Although phenotypic susceptibility testing forms the cornerstone, there are limitations in accuracy depending on the method used [8]. This problem is further compounded by the finding that most mcr-1 -producing isolates have lower colistin MICs in the range of 2–4 mcg/mL, and some isolates that are phenotypically susceptible may produce mcr-1 [2]. Therefore, our study may have underdetected mcr-1 , both due to issues with polymyxin susceptibility testing and because our screening strategy required isolates to initially have resistance to third-generation cephalosporins.…”
Section: Discussionmentioning
confidence: 99%
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