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Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 11/2017

01-11-2017 | Antimicrobial Development and Drug Resistance (A Pakyz, Section Editor)

Polymyxin Resistance in Gram-negative Pathogens

Authors: Pavithra Srinivas, Kaitlyn Rivard

Published in: Current Infectious Disease Reports | Issue 11/2017

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Abstract

Purpose of Review

The polymyxins are one of the last line antimicrobial classes to retain activity against multidrug-resistant Gram-negative bacilli. However, with the increased use of polymyxins in recent years, reports of resistance have also been increasing. We aimed to describe the mechanisms and occurrence of polymyxin resistance in Gram-negative organisms and propose strategies to overcome resistance.

Recent Findings

The most common mechanism of acquired resistance to the polymyxins is via modification of the bacterial outer membrane lipopolysaccharide. Global epidemiological surveillance studies have reported the occurrence of polymyxin resistance to be most common in Enterobacteriaceae, specifically Enterobacter species and Acinetobacter baumannii. Prevalence of polymyxin-resistant Gram-negative organisms varies significantly by geographical location.

Summary

Emergence of polymyxin resistance is of great concern, given the limited number of agents available to treat infections caused by multidrug-resistant Gram-negative organisms. Strategies to mitigate the development of polymyxin resistance include dose optimization and using polymyxin agents in combination with other highly active antimicrobial agents.
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Metadata
Title
Polymyxin Resistance in Gram-negative Pathogens
Authors
Pavithra Srinivas
Kaitlyn Rivard
Publication date
01-11-2017
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 11/2017
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0596-3

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