Research Advances in Mechanisms of Bacterial Resistance to Polymyxins and Related Detection Methods
Polymyxins are polycationic antimicrobial peptides that are currently served as the last-line antibiotics for the treatment of multidrug-resistant Gram-negative bacterial infections.Reports of polymyxin resistance in clinical isolates have been recently increased,which is becoming a serious public health issue and should be of great concern.Research advances in mechanisms of bacterial resistance to polymyxins and related detection methods are introduced in this paper in order to facilitate future studies.The reason of natural to polymyxin and the mechanism of acquired resistance were analyzed,and the effects of chromosome-mediated LPS modification,plasmid-mediated LPS modification and heterogeneous resistance were discussed.This article also introduces the methods of drug resistance detection,including phenotype detection and molecular biology methods.At present,there is a need for clinical microbiology laboratories to increase routine testing for polymyxin resistance in Gram-negative bacteria.As the prevalence risk of pan-and full-resistance to polymyxin is increasing,the presence of multiple resistance mechanisms in a bacterial strain makes routine detection more difficult.The simultaneous detection of phenotype and molecular methods is easier to interpret and judge the results,and is also simple and convenient,suggesting that the possibility of simultaneous detection of multiple resistance mechanisms is to be expected.
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