Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Pharmaceutical Design
  4. Volume 30, Issue 36
  5. Article
Volume 30, Issue 36
  • ISSN: 1381-6128
  • E-ISSN: 1873-4286

Abstract

Globally, gram-negative bacteria are a significant cause of morbidity. Multi-drug resistance bacteria are responsible for an increasing surge in infections that place a high cost on healthcare systems around the world. Recently, colistin, an antibiotic belonging to the polymyxin family, was reintroduced to combat multi- drug-resistant gram-negative bacteria. Excessive and persistent use of colistin has led to the development and spread of colistin-resistant gram-negative bacteria throughout the globe. Healthcare units in various countries, including Saudi Arabia, are currently battling colistin-resistant gram-negative bacteria. Recently, colistin-resistant gram-negative bacteria have become a major health concern in Saudi Arabia. Hence, extensive epidemiological surveys and studies are required to understand the current status of the colistin antibiotic. Examining the knowledge currently available to the medical community on the molecular mechanism, clinical effectiveness, molecular epidemiology, and bacterial resistance to colistin in Saudi Arabia is the aim of this review.

© 2024 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cpd/10.2174/0113816128303422240723091231
2024-08-06
2024-12-25

  • From This Site

    /content/journals/cpd/10.2174/0113816128303422240723091231
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. NewtonB.A. The properties and mode of action of the polymyxins.Bacteriol. Rev.1956201142710.1128/br.20.1.14‑27.195613303920
     [Google Scholar]
  2. NationR.L. VelkovT. LiJ. Colistin and polymyxin B: Peas in a pod, or chalk and cheese?Clin. Infect. Dis.2014591889410.1093/cid/ciu21324700659
     [Google Scholar]
  3. FalagasM.E. KasiakouS.K. SaravolatzL.D. Colistin: The revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections.Clin. Infect. Dis.20054091333134110.1086/42932315825037
     [Google Scholar]
  4. StormD.R. RosenthalK.S. SwansonP.E. Polymyxin and related peptide antibiotics.Annu. Rev. Biochem.197746172376310.1146/annurev.bi.46.070177.003451197881
     [Google Scholar]
  5. PoudyalA. HowdenB.P. BellJ.M. GaoW. OwenR.J. TurnidgeJ.D. NationR.L. LiJ. In vitro pharmacodynamics of colistin against multidrug-resistant Klebsiella pneumoniae.J. Antimicrob. Chemother.20086261311131810.1093/jac/dkn42518922815
     [Google Scholar]
  6. OwenR.J. LiJ. NationR.L. SpelmanD. In vitro pharmacodynamics of colistin against Acinetobacter baumannii clinical isolates.J. Antimicrob. Chemother.200759347347710.1093/jac/dkl51217289768
     [Google Scholar]
  7. CaiY. ChaiD. WangR. LiangB. BaiN. Colistin resistance of Acinetobacter baumannii: Clinical reports, mechanisms and antimicrobial strategies.J. Antimicrob. Chemother.20126771607161510.1093/jac/dks08422441575
     [Google Scholar]
  8. LandmanD. GeorgescuC. MartinD.A. QualeJ. Polymyxins revisited.Clin. Microbiol. Rev.200821344946510.1128/CMR.00006‑0818625681
     [Google Scholar]
  9. LiJ. NationR.L. TurnidgeJ.D. MilneR.W. CoulthardK. RaynerC.R. PatersonD.L. Colistin: The re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections.Lancet Infect. Dis.20066958960110.1016/S1473‑3099(06)70580‑116931410
     [Google Scholar]
  10. JeannotK. BolardA. PlésiatP. Resistance to polymyxins in Gram-negative organisms.Int. J. Antimicrob. Agents201749552653510.1016/j.ijantimicag.2016.11.02928163137
     [Google Scholar]
  11. Al-TawfiqJ.A. LaxminarayanR. MendelsonM. How should we respond to the emergence of plasmid-mediated colistin resistance in humans and animals?Int. J. Infect. Dis.201754778410.1016/j.ijid.2016.11.41527915108
     [Google Scholar]
  12. KarvanenM. Optimization of colistin dosage in the treatment of multiresistant Gram-negative infections.Doctoral dissertation, Acta Universitatis Upsaliensis2013
     [Google Scholar]
  13. El-Sayed AhmedM.A.E.G. ZhongL.L. ShenC. YangY. DoiY. TianG.B. Colistin and its role in the era of antibiotic resistance: An extended review (2000–2019).Emerg. Microbes Infect.20209186888510.1080/22221751.2020.175413332284036
     [Google Scholar]
  14. NationR.L. LiJ. Colistin in the 21st century.Curr. Opin. Infect. Dis.200922653554310.1097/QCO.0b013e328332e67219797945
     [Google Scholar]
  15. BiswasS. BrunelJ.M. DubusJ.C. Reynaud-GaubertM. RolainJ.M. Colistin: An update on the antibiotic of the 21st century.Expert Rev. Anti Infect. Ther.201210891793410.1586/eri.12.7823030331
     [Google Scholar]
  16. FaidahH.S. Colistin use and its resistance in Kingdom of Saudi Arabia: A narrative review.Adv. Infect. Dis.20188425526110.4236/aid.2018.84021
     [Google Scholar]
  17. AlotaibiF. Carbapenem-resistant Enterobacteriaceae: An update narrative review from Saudi Arabia.J. Infect. Public Health201912446547110.1016/j.jiph.2019.03.02431060974
     [Google Scholar]
  18. WalaaM.S. SamahG. HatemM.E.S. NikhatM. Assessment of antimicrobial resistance patterns in Escherichia coli isolated from clinical samples in Madinah, Saudi Arabia.Afr. J. Microbiol. Res.2018121332132610.5897/AJMR2018.8836
     [Google Scholar]
  19. Al-ZahraniI.A. AlasiriB.A. The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir) province, Saudi Arabia.Saudi Med. J.2018391233010.15537/smj.2018.1.2109429332105
     [Google Scholar]
  20. AbdalhamidB. ElhadiN. AlabdulqaderN. AlsammanK. AljindanR. Rates of gastrointestinal tract colonization of carbapenem-resistant Enterobacteriaceae and Pseudomonas aeruginosa in hospitals in Saudi Arabia.New Microbes New Infect.201610778310.1016/j.nmni.2016.01.01426933499
     [Google Scholar]
  21. ForsterA.J. TaljaardM. OakeN. WilsonK. RothV. van WalravenC. The effect of hospital-acquired infection with Clostridium difficile on length of stay in hospital.CMAJ20121841374210.1503/cmaj.11054322143235
     [Google Scholar]
  22. AliS. BirhaneM. BekeleS. KibruG. TeshagerL. YilmaY. AhmedY. FentahunN. AssefaH. GashawM. GudinaE.K. Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: Longitudinal study.Antimicrob. Resist. Infect. Control201871210.1186/s13756‑017‑0298‑529312659
     [Google Scholar]
  23. O'NeillJ. Tackling drug-resistant infections globally: Final report and recommendations.2016Available from: https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf
  24. VincentJ.L. RelloJ. MarshallJ. SilvaE. AnzuetoA. MartinC.D. MorenoR. LipmanJ. GomersallC. SakrY. ReinhartK. International study of the prevalence and outcomes of infection in intensive care units.JAMA2009302212323232910.1001/jama.2009.175419952319
     [Google Scholar]
  25. AliE. AlbarraqA. MakeenH. EzziA. MashragiY.M. Intravenous colistin in the treatment of multidrug-resistant Gram-negative organism in tertiary hospital, Jazan, KSA.J. Family Med. Prim. Care202110133333810.4103/jfmpc.jfmpc_1148_2034017749
     [Google Scholar]
  26. CaraA.K.S. ZaidiS.T.R. SulemanF. Cost-effectiveness analysis of low versus high dose colistin in the treatment of multi-drug resistant pneumonia in Saudi Arabia.Int. J. Clin. Pharm.20184051051105810.1007/s11096‑018‑0713‑x30117080
     [Google Scholar]
  27. SharmaJ. SharmaD. SinghA. SunitaK. Colistin resistance and management of drug resistant infections.Can. J. Infect. Dis. Med. Microbiol.2022202211010.1155/2022/431503036536900
     [Google Scholar]
  28. IbrahimM.E. High antimicrobial resistant rates among Gram-negative pathogens in intensive care units.Saudi Med. J.201839101035104310.15537/smj.2018.10.2294430284588
     [Google Scholar]
  29. BoonyasiriA. BrinkacL.M. JauneikaiteE. WhiteR.C. GrecoC. SeenamaC. TangkoskulT. NguyenK. FoutsD.E. ThamlikitkulV. Characteristics and genomic epidemiology of colistin-resistant Enterobacterales from farmers, swine, and hospitalized patients in Thailand, 2014–2017.BMC Infect. Dis.202323155610.1186/s12879‑023‑08539‑837641085
     [Google Scholar]
  30. GharaibehM.H. ShatnawiS.Q. An overview of colistin resistance, mobilized colistin resistance genes dissemination, global responses, and the alternatives to colistin: A review.Vet. World201912111735174610.14202/vetworld.2019.1735‑174632009752
     [Google Scholar]
  31. Delgarm Shams-AbadiA. Mohammadian-HafshejaniA. PatersonD.L. ArashR. Asadi FarsaniE. TajiA. HeidariH. Shahini Shams AbadiM. The prevalence of colistin resistance in clinical Stenotrophomonas maltophilia isolates worldwide: A systematic review and meta-analysis.BMC Microbiol.202323120010.1186/s12866‑023‑02950‑637507660
     [Google Scholar]
  32. ZhangY. LvX. CaoW. ZhangH. ShiL. BaiW. YeL. Survey of colistin resistance in commensal bacteria from Penaeus vannamei farms in China.Foods20231211214310.3390/foods1211214337297388
     [Google Scholar]
  33. ElbediwiM. LiY. PaudyalN. PanH. LiX. XieS. RajkovicA. FengY. FangW. RankinS.C. YueM. Global burden of colistin-resistant bacteria: Mobilized colistin resistance genes study (1980–2018).Microorganisms201971046110.3390/microorganisms710046131623244
     [Google Scholar]
  34. BinskerU. KäsbohrerA. HammerlJ.A. Global colistin use: A review of the emergence of resistant Enterobacterales and the impact on their genetic basis.FEMS Microbiol. Rev.2022461fuab04910.1093/femsre/fuab04934612488
     [Google Scholar]
  35. Al-AgamyM.H. JeannotK. El-MahdyT.S. ShiblA.M. KattanW. PlésiatP. CourvalinP. First detection of GES-5 carbapenemase-producing Acinetobacter baumannii isolate.Microb. Drug Resist.201723555656210.1089/mdr.2016.015227854148
     [Google Scholar]
  36. Al-AgamyM.H. ShiblA.M. HafezM.M. Al-AhdalM.N. MemishZ.A. KhubnaniH. Molecular characteristics of extended-spectrum β-lactamase-producing Escherichia coli in Riyadh: Emergence of CTX-M-15-producing E. coli ST131.Ann. Clin. Microbiol. Antimicrob.2014131410.1186/1476‑0711‑13‑424397567
     [Google Scholar]
  37. SonnevendÁ. GhazawiA. AlqahtaniM. ShiblA. JamalW. HashmeyR. PalT. Plasmid-mediated colistin resistance in Escherichia coli from the Arabian Peninsula.Int. J. Infect. Dis.201650859010.1016/j.ijid.2016.07.00727566913
     [Google Scholar]
  38. AlghoribiM.F. DoumithM. UptonM. Al JohaniS.M. AlzayerM. WoodfordN. EllingtonM.J. BalkhyH.H. Complete genome sequence of a colistin-resistant uropathogenic Escherichia coli sequence type 131 fimH 22 strain harboring mcr-1 on an IncHI2 plasmid, isolated in Riyadh, Saudi Arabia.Microbiol. Resour. Announc.2019818e00104-1910.1128/MRA.00104‑1931048392
     [Google Scholar]
  39. AzimN.S. Al-HarbiM.A. Al-ZabanM.I. NofalM.Y. SomilyA.M. Prevalence and antibiotic susceptibility among gram negative bacteria isolated from intensive care units at a Tertiary Care Hospital in Riyadh, Saudi Arabia.J. Pure Appl. Microbiol.20191320120810.22207/JPAM.13.1.21
     [Google Scholar]
  40. RamadanR.A. GebrielM.G. KadryH.M. MosallemA. Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa : Characterization of carbapenemase genes and E-test evaluation of colistin-based combinations.Infect. Drug Resist.2018111261126910.2147/IDR.S17023330197524
     [Google Scholar]
  41. SaeedN.K. KambalA.M. El-KhizziN.A. Antimicrobial-resistant bacteria in a general intensive care unit in Saudi Arabia.Saudi Med. J.201031121341134921135998
     [Google Scholar]
  42. GarbatiM.A. Bin AbdulhakA. BabaK. SakkijhaH. Infection due to colistin-resistant Enterobacteriacae in critically-ill patients.J. Infect. Dev. Ctries.201371071371910.3855/jidc.285124129623
     [Google Scholar]
  43. RanaM.A. Abd El RahamanB. MadyA.F. Al OdatM. Al HarthyA. RamadanO.E.S. MumtazS.A. OmraniA.S. Intra-pleural colistin methanesulfonate therapy for pleural infection caused by carbapenem-resistant Acinetobacter baumannii: A successful case report.Infect. Dis. Rep.201463541310.4081/idr.2014.541325276329
     [Google Scholar]
  44. BukharyZ. MahmoodW. Al-KhaniA. Al-AbdelyH.M. Treatment of nosocomial meningitis due to a multidrug resistant Acinetobacter baumannii with intraventricular colistin.Saudi Med. J.200526465665815900379
     [Google Scholar]
  45. PengD. ZhangF. ChenY. ZhaoC. NiuJ. YangJ. LiZ. ChenC. QiuS. ZhangH. QinB. FangX. GuoS. LiuY. ShaoH. Efficacy and safety of colistin sulfate in the treatment of infections caused by carbapenem-resistant organisms: A multicenter retrospective cohort study.J. Thorac. Dis.20231541794180410.21037/jtd‑23‑33637197520
     [Google Scholar]
  46. WuY. JiangS. LiD. WuY. LiQ. WangX. LiuB. BaoH. WuD. HuX. Clinical efficacy and safety of colistin sulfate in the treatment of carbapenem-resistant organism infections in patients with hematological diseases.Infect. Dis. Ther.202413114115410.1007/s40121‑023‑00909‑838212555
     [Google Scholar]
  47. Garnacho-MonteroJ. Amaya-VillarR. Gutiérrez-PizarrayaA. Espejo-Gutiérrez de TenaE. Artero-GonzálezM.L. Corcia-PalomoY. Bautista-PalomaJ. Clinical efficacy and safety of the combination of colistin plus vancomycin for the treatment of severe infections caused by carbapenem-resistant Acinetobacter baumannii.Chemotherapy201359322523110.1159/00035600424356297
     [Google Scholar]
  48. MichalopoulosA.S. FalagasM.E. Colistin: Recent data on pharmacodynamics properties and clinical efficacy in critically ill patients.Ann. Intensive Care2011113010.1186/2110‑5820‑1‑3021906382
     [Google Scholar]
  49. ZhangH. ZhangQ. Systemic review/meta-analysis clinical efficacy and safety of colistin treatment in patients with pulmonary infection caused by Pseudomonas aeruginosa or Acinetobacter baumannii: A meta-analysis.Arch. Med. Sci.201511344210.5114/aoms.2015.4815825861288
     [Google Scholar]
  50. Al ShirawiN. MemishZ.A. CherfanA. Al ShimemeriA. Post-neurosurgical meningitis due to multidrug-resistant Acinetobacter baumanii treated with intrathecal colistin: Case report and review of the literature.J. Chemother.200618555455810.1179/joc.2006.18.5.55417127235
     [Google Scholar]
  51. Rico CaballeroV. Almarzoky AbuhussainS. KutiJ.L. NicolauD.P. Efficacy of human-simulated exposures of ceftolozane-tazobactam alone and in combination with amikacin or colistin against multidrug-resistant Pseudomonas aeruginosa in an in vitro pharmacodynamic model.Antimicrob. Agents Chemother.2018625e02384-1710.1128/AAC.02384‑1729483119
     [Google Scholar]
  52. Uz ZamanT. AlbladiM. SiddiqueM.I. Al JohaniS.M. BalkhyH. Insertion element mediated mgrB disruption and presence of ISKpn28 in colistin-resistant Klebsiella pneumoniae isolates from Saudi Arabia.Infect. Drug Resist.2018111183118710.2147/IDR.S16114630147346
     [Google Scholar]
  53. CascioA. ContiA. SinardiL. IariaC. AngileriF.F. StassiG. DavidT. VersaciA. IariaM. DavidA. Post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature.Int. J. Infect. Dis.2010147e572e57910.1016/j.ijid.2009.06.03219892577
     [Google Scholar]
  54. LohoT. DharmayantiA. Colistin: An antibiotic and its role in multiresistant Gram-negative infections.Acta Med. Indones.201547215716826260559
     [Google Scholar]
  55. HaseebA. FaidahH.S. AlghamdiS. AlotaibiA.F. ElrggalM.E. MahrousA.J. Almarzoky AbuhussainS.S. ObaidN.A. AlgethamyM. AlQarniA. KhogeerA.A. SaleemZ. SheikhA. Dose optimization of colistin: A systematic review.Antibiotics (Basel)20211012145410.3390/antibiotics1012145434943666
     [Google Scholar]
  56. ZaidiS.T.R. Al OmranS. Al AithanA.S.M. Al SultanM. Efficacy and safety of low-dose colistin in the treatment for infections caused by multidrug-resistant Gram-negative bacteria.J. Clin. Pharm. Ther.201439327227610.1111/jcpt.1213824593154
     [Google Scholar]
  57. MarkouN. MarkantonisS.L. DimitrakisE. PanidisD. BoutzoukaE. KaratzasS. RafailidisP. ApostolakosH. BaltopoulosG. Colistin serum concentrations after intravenous administration in critically ill patients with serious multidrug-resistant, Gram-negative bacilli infections: A prospective, open-label, uncontrolled study.Clin. Ther.200830114315110.1016/j.clinthera.2008.01.01518343250
     [Google Scholar]
  58. PlachourasD. KarvanenM. FribergL.E. PapadomichelakisE. AntoniadouA. TsangarisI. KaraiskosI. PoulakouG. KontopidouF. ArmaganidisA. CarsO. GiamarellouH. Population pharmacokinetic analysis of colistin methanesulfonate and colistin after intravenous administration in critically ill patients with infections caused by Gram-negative bacteria.Antimicrob. Agents Chemother.20095383430343610.1128/AAC.01361‑0819433570
     [Google Scholar]
  59. MohamedA.F. KaraiskosI. PlachourasD. KarvanenM. PontikisK. JanssonB. PapadomichelakisE. AntoniadouA. GiamarellouH. ArmaganidisA. CarsO. FribergL.E. Application of a loading dose of colistin methanesulfonate in critically ill patients: Population pharmacokinetics, protein binding, and prediction of bacterial kill.Antimicrob. Agents Chemother.20125684241424910.1128/AAC.06426‑1122615285
     [Google Scholar]
  60. OmraniA.S. AlfahadW.A. ShoukriM.M. BaadaniA.M. AldalbahiS. AlmitwaziA.A. AlbarrakA.M. High dose intravenous colistin methanesulfonate therapy is associated with high rates of nephrotoxicity; A prospective cohort study from Saudi Arabia.Ann. Clin. Microbiol. Antimicrob.2015141310.1186/s12941‑015‑0062‑825591721
     [Google Scholar]
  61. AlmutairyR. AljrarriW. NoorA. ElsamadisiP. ShamasN. QureshiM. IsmailS. Impact of colistin dosing on the incidence of nephrotoxicity in a tertiary care hospital in Saudi Arabia.Antibiotics (Basel)20209848510.3390/antibiotics908048532781593
     [Google Scholar]
  62. NationR.L. LiJ. CarsO. CouetW. DudleyM.N. KayeK.S. MoutonJ.W. PatersonD.L. TamV.H. TheuretzbacherU. TsujiB.T. TurnidgeJ.D. Framework for optimisation of the clinical use of colistin and polymyxin B: The Prato polymyxin consensus.Lancet Infect. Dis.201515222523410.1016/S1473‑3099(14)70850‑325459221
     [Google Scholar]
  63. BaadaniA.M. ThawadiS.I. El-KhizziN.A. OmraniA.S. Prevalence of colistin and tigecycline resistance in Acinetobacter baumannii clinical isolates from 2 hospitals in Riyadh region over a 2-year period.Saudi Med. J.201334324825323475088
     [Google Scholar]
  64. ShiblA. Al-AgamyM. MemishZ. SenokA. KhaderS.A. AssiriA. The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia.Int. J. Infect. Dis.20131712e1130e113310.1016/j.ijid.2013.06.01624021566
     [Google Scholar]
  65. AlqasimA. Colistin-resistant Gram-negative bacteria in Saudi Arabia: A literature review.J. King Saud Univ. Sci.202133810161010.1016/j.jksus.2021.101610
     [Google Scholar]
  66. Al MayahiZ. KamelS. AmerH. BeattyM. Outbreak of colistin-resistant organisms at a tertiary hospital in Riyadh, Saudi Arabia, 2016.Pan Afr. Med. J.20193416210.11604/pamj.2019.34.162.1999832153702
     [Google Scholar]
  67. KharabaA. Prevalence and outcomes of colistin-resistant Acinetobacter infection in Saudi critical care units.Saudi Crit Care J2017162510.4103/sccj.sccj_28_17
     [Google Scholar]
  68. GogryF.A. SiddiquiM.T. SultanI. HaqQ.M.R. Current update on intrinsic and acquired colistin resistance mechanisms in bacteria.Front. Med. (Lausanne)2021867772010.3389/fmed.2021.67772034476235
     [Google Scholar]
  69. HamelM. RolainJ.M. BaronS.A. The history of colistin resistance mechanisms in bacteria: Progress and challenges.Microorganisms20219244210.3390/microorganisms902044233672663
     [Google Scholar]
  70. TorresD.A. Seth-SmithH.M.B. JoosseN. LangC. DubuisO. Nüesch-InderbinenM. HinicV. EgliA. Colistin resistance in Gram-negative bacteria analysed by five phenotypic assays and inference of the underlying genomic mechanisms.BMC Microbiol.202121132110.1186/s12866‑021‑02388‑834798825
     [Google Scholar]
  71. AlbaP. LeekitcharoenphonP. FrancoA. FeltrinF. IanzanoA. CaprioliA. StravinoF. HendriksenR.S. BortolaiaV. BattistiA. Molecular epidemiology of mcr-encoded colistin resistance in Enterobacteriaceae from food-producing animals in Italy revealed through the EU harmonized antimicrobial resistance monitoring.Front. Microbiol.20189121710.3389/fmicb.2018.0121729951045
     [Google Scholar]
  72. AbdallahM. BalshiA. First literature review of carbapenem-resistant Providencia. New Microbes New Infect.201825162310.1016/j.nmni.2018.05.00929983987
     [Google Scholar]
  73. Al-QahtaniA.A. Al-AgamyM.H. AliM.S. Al-AhdalM.N. AljohiM.A. ShiblA.M. Characterization of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae from Riyadh, Saudi Arabia.J. Chemother.201426313914510.1179/1973947813Y.000000012424091155
     [Google Scholar]
  74. AbdalhamidB. HassanH. ItbailehA. ShormanM. Characterization of carbapenem-resistant Acinetobacter baumannii clinical isolates in a tertiary care hospital in Saudi Arabia.New Microbiol.2014371657324531172
     [Google Scholar]
  75. LeangapichartT. GautretP. BrouquiP. MimishZ. RaoultD. RolainJ.M. Acquisition of mcr-1 plasmid-mediated colistin resistance in Escherichia coli and Klebsiella pneumoniae during Hajj 2013 and 2014.Antimicrob. Agents Chemother.201660116998699910.1128/AAC.01486‑1627620480
     [Google Scholar]
/content/journals/cpd/10.2174/0113816128303422240723091231
Loading

  • Article Type:     Review Article
Keyword(s): clinical efficacy; Colistin; gram-negative bacteria; molecular epidemiology, multi-drug resistance, healthcare systems

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test