From Molecule to Microbe: Exploring the Chemistry, Mechanistic Insights, Resistance Mechanisms, and Phenotypic Detection of Colistin Resistance | ||
| Archives of Pharmaceutical Sciences Ain Shams University | ||
| Articles in Press, Accepted Manuscript, Available Online from 15 November 2025 | ||
| Document Type: Review Article | ||
| DOI: 10.21608/aps.2025.406053.1240 | ||
| Authors | ||
| Fatma S. Rashad1; Sarra E. Saleh* 2; Mahmoud A. Yassien3; Nadia Hassouna4 | ||
| 1Department of Microbiology and immunology, Faculty of Pharmacy, Ain Shams University | ||
| 2Department of Microbiology and immunology, Faculty of pharmacy Ain Shams University | ||
| 3Department of Microbiology and Immunology, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt | ||
| 4Faculty of Pharmacy, Ain shams university | ||
| Abstract | ||
| Colistin, a polymyxin antibiotic, is an essential last-resort agent that was discovered in the late 1940s for the treatment of severe infections brought on by pan-drug-resistant (PDR), extensively drug-resistant (XDR), and multidrug-resistant (MDR) Gram-negative bacteria (GNB), particularly Enterobacteriaceae such as Klebsiella pneumoniae and E. coli, as well as Pseudomonas and Acinetobacter. Despite its efficacy and utility as a final line antibiotic, the emerging of colistin resistance has been rising. Resistance mechanisms to colistin involve chromosomal mutations that alter the colistin’s binding target, upregulation of efflux pumps, and plasmid-mediated mcr genes, which enable horizontal gene transfer and rapid dissemination among bacterial populations. This review focuses on the mode of action of colistin, with special attention to resistance mechanisms, particularly the alarming spread of mcr genes worldwide. Furthermore, it discusses phenotypic methods for detecting colistin resistance, which are vital for clinical surveillance and antibiotic stewardship programs. Understanding these resistance pathways is critical for guiding treatment strategies and controlling the spread of resistant pathogens in healthcare settings. | ||
| Keywords | ||
| Colistin; Grame negative; mcr genes; Phenotypic; Polymyxin | ||
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