:: Volume 25, Issue 6 (Scientific Journal of Kurdistan University of Medical Sciences 2021) ::
SJKU 2021, 25(6): 90-102 Back to browse issues page
Colistin: Mechanisms of antibiotic resistance and logical approach to its use Fariba Lahoorpour
Fariba Lahoorpour
Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran , lahoorpour@gmail.com
Abstract:   (192 Views)
Background and Aim: In recent decades, widespread antibiotic resistance in nosocomial infections due to gram-negative bacteria which can cause high mortality rates have significantly increased, especially in intensive care units. Polymyxin resistance, colistin in particular, as the last therapeutic resort, has been reported globally. The purpose of this study was to evaluate the mechanisms of resistance to colistin and the logical approach to the use of this antibiotic.
Materials and Methods: The research method was a narrative review. Data were collected by searching WOS (Web of Science), Scopus, PubMed, SID (Scientific Information Database), Science Direct, and Google Scholar search engines by using the keywords of colistin, antibiotic resistance, gram-negative bacteria, epidemiology, Iran, extended-spectrum beta-lactamases (ESBLs), molecular mechanisms or combinations of them from 2000 to 2019.
Results: The most common molecular mechanisms of colistin resistance were mcr-1, mcr-like genes, increased pmrC expression, outer membrane changes in gram-negative bacteria, and mutations in the mgrB. Combination therapy using colistin with other antibiotics was an effective treatment strategy in life-threatening infections.
Conclusion: mcr-1 and pet-1 transferase were the most prevalent molecular mechanisms for colistin resistance and combinations of colistin with other antibiotics were effective in the treatment of severe infections
Keywords: Colistin, Gram-negative bacteria, Molecular mechanisms, Antibiotic resistance, Combination therapy
Full-Text [PDF 339 kb]   (72 Downloads)    
Type of Study: Research | Subject: General
Received: 2019/09/15 | Accepted: 2020/03/14 | Published: 2021/01/29

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Volume 25, Issue 6 (Scientific Journal of Kurdistan University of Medical Sciences 2021) Back to browse issues page