On the edge of a precipice: the global emergence and dissemination of plasmid-borne mcr genes that confer resistance to colistin, a last-resort antibiotic

摘要: Abstract Colistin (polymyxin E) is used as a last-resort antibiotic to treat complicated infections with gram-negative bacteria. However, global dissemination of transmissible plasmid-borne resistance colistin has been reported recently. This can potentially severely limit the treatment multidrug-resistant infections, which raised public health concerns. Despite attention, data on and mobile colistin-resistance genes (mcr) remain scarce in countries developing antimicrobial stewardship. The latter applies many Middle East North Africa (MENA) region, where use antibiotics human medicine conventional farming practices not necessarily well regulated. Furthermore, MENA have witnessed calamitous events such wars, loss vital resources infrastructure, displacement large populations (refugees), while region hosts largest multinational religious gatherings world. These conditions are ideal for emergence transmission pathogens resistance-encoding genes. Subsequently, monitoring efficacy paramount importance local health. Here, we review available mcr associated globally. We also mapped occurrence sources different first time. conclude that there need more surveillance analysis routes these worldwide emphasis should be placed resource-limited like those region. argue essential order curb spread mcr-associated resistance.