Antimicrobial Susceptibility Testing for Polymyxins: Challenges, Issues, and Recommendations

Overview

Journal J Clin Microbiol

Specialty Microbiology

Date 2018 Dec 14

PMID 30541939

Citations 53

Authors

Fereshteh Ezadi

Abdollah Ardebili

Reza Mirnejad

Affiliations

Soon will be listed here.

Abstract

Polymyxins, including polymyxin B and polymyxin E (colistin), are now increasingly being used worldwide to treat patients with multidrug-resistant (MDR) Gram-negative bacterial infections. This necessitates that laboratories employ an accurate and reliable method for the routine performance of polymyxin susceptibility testing. A number of reasons have accounted for the difficulties with susceptibility testing for the polymyxins, including their multicomponent composition, poor diffusion in the agar medium, adsorption to microtiter plates, the lack of a reliable susceptibility test, the lack of a specific breakpoint from professional organizations, the synergistic effect of polysorbate 80, and the development of heteroresistance. This minireview discusses such problems that impact the results of currently available susceptibility testing methods. We also provide emerging concepts on mechanisms of polymyxin resistance, including chromosomally and plasmid-mediated -related resistance. Broad-range investigations on such critical issues in relation to polymyxins can be beneficial for the implementation of effective treatment against MDR Gram-negative bacterial infections.

Citing Articles

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Comparative Analysis of Colistin Resistance in Pseudomonas aeruginosa: VITEK® 2 Compact Versus Broth Microdilution Method.

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Antimicrobial proteins from oyster hemolymph improve the efficacy of conventional antibiotics.

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