Colistin Update on Its Mechanism of Action and Resistance, Present and Future Challenges

Microorganisms - Tập 8 Số 11 - Trang 1716
Ferdinando F. Andrade1,2, Daniela Silva3,4, Acácio G. Rodrigues5,6,1, Cidália Pina‐Vaz6,1
1Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
2Farmanimal Veterinary Centre, 2500-323 Caldas da Rainha, Portugal
3Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
4Clinical Microbiology Department, Porto University Hospital Center, 4099-001 Porto, Portugal
5Burn Unit, S. João University Hospital Center, 4200-319 Porto, Portugal
6CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal

Tóm tắt

Colistin has been extensively used since the middle of the last century in animals, particularly in swine, for the control of enteric infections. Colistin is presently considered the last line of defense against human infections caused by multidrug-resistant Gram-negative organisms such as carbapenemase-producer Enterobacterales, Acinetobacter baumanni, and Pseudomonas aeruginosa. Transferable bacterial resistance like mcr-genes was reported in isolates from both humans and animals. Researchers actively seek strategies to reduce colistin resistance. The definition of guidelines for colistin therapy in veterinary and human medicine is thus crucial. The ban of colistin use in swine as a growth promoter and for prophylactic purposes, and the implementation of sustainable measures in farm animals for the prevention of infections, would help to avoid resistance and should be encouraged. Colistin resistance in the human–animal–environment interface stresses the relevance of the One Health approach to achieve its effective control. Such measures should be addressed in a cooperative way, with efforts from multiple disciplines and with consensus among doctors, veterinary surgeons, and environment professionals. A revision of the mechanism of colistin action, resistance, animal and human use, as well as colistin susceptibility evaluation is debated here.

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Tài liệu tham khảo

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Microorganisms

Tập 8 Số 11

1716

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