The global spread of carbapenemase-encoding genes among Gram-negative nosocomial
pathogens has led to the revival of polymyxins. Colistin and polymyxin B, despite
their serious adverse effects, have become last resort treatment options for multi- or even
extensively-drug-resistant bacterial infections due to Klebsiella pneumoniae, Acinetobacter
baumannii and Pseudomonas aeruginosa. Their use, however, has been followed by an increase
in polymyxin resistance rates and the spread of transferable resistance genes limiting
further the treatment options and contributing to the emergence of pan-drug-resistance. In
the present review, the to-date known polymyxin resistance mechanisms, as well as patents
related to polymyxin resistance, are discussed.
Keywords: Polymyxin, colistin, mcr-1, mgrB, resistance, carbapenemase-encoding genes.
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