Infection and Drug Resistance (Apr 2019)

Molecular mechanisms related to colistin resistance in Enterobacteriaceae

  • Aghapour Z,
  • Gholizadeh P,
  • Ganbarov K,
  • Bialvaei AZ,
  • Mahmood SS,
  • Tanomand A,
  • Yousefi M,
  • Asgharzadeh M,
  • Yousefi B,
  • Kafil HS

Journal volume & issue
Vol. Volume 12
pp. 965 – 975

Abstract

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Zahra Aghapour,1,2 Pourya Gholizadeh,3 Khudaverdi Ganbarov,4 Abed Zahedi Bialvaei,5 Suhad Saad Mahmood,6 Asghar Tanomand,7 Mehdi Yousefi,8 Mohammad Asgharzadeh,9 Bahman Yousefi,9 Hossein Samadi Kafil11Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; 3Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 4Department of Microbiology, Baku State University, Baku, Azerbaijan; 5Department of Microbiology, Iran University of Medical Sciences, Tehran, Iran; 6Department of Biotechnology, College of Science, University of Baghdad, Baghdad, Iraq; 7Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran; 8Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 9Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IranAbstract: Colistin is an effective antibiotic for treatment of most multidrug-resistant Gram-negative bacteria. It is used currently as a last-line drug for infections due to severe Gram-negative bacteria followed by an increase in resistance among Gram-negative bacteria. Colistin resistance is considered a serious problem, due to a lack of alternative antibiotics. Some bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Enterobacteriaceae members, such as Escherichia coli, Salmonella spp., and Klebsiella spp. have an acquired resistance against colistin. However, other bacteria, including Serratia spp., Proteus spp. and Burkholderia spp. are naturally resistant to this antibiotic. In addition, clinicians should be alert to the possibility of colistin resistance among multidrug-resistant bacteria and development through mutation or adaptation mechanisms. Rapidly emerging bacterial resistance has made it harder for us to rely completely on the discovery of new antibiotics; therefore, we need to have logical approaches to use old antibiotics, such as colistin. This review presents current knowledge about the different mechanisms of colistin resistance.Keywords: colistin, Enterobacteriaceae, two-component system, lipid A, mcr genes

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