Resistance to colistin in Klebsiella pneumoniae: a 4.0 strain?

• Main Authors: Guido Granata, Nicola Petrosillo
• Format: Article
• Language: English
• Published: MDPI AG 2017-05-01
• Series: Infectious Disease Reports
• Online Access: http://www.pagepress.org/journals/index.php/idr/article/view/7104

The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gramnegative bacteria a global spread of extendedspectrum beta-lactamases and carbapenemases producing <em>Klebsiella</em> <em>pneumoniae</em> has been observed. Treatment options for multidrug-resistant <em>K. pneumoniae</em> are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline- resistant <em>K. pneumoniae</em> is increasing globally. Infection due to colistin-resistant <em>K. pneumoniae</em> represents an independent risk factor for mortality. Resistance to colistin in <em>K. pneumoniae</em> may be multifactorial, as it is mediated by chromosomal genes or plasmids. The emergence of transmissible, plasmidmediated colistin resistance is an alarming finding. The absence of new agents effective against resistant Gram-negative pathogens means that enhanced surveillance, compliance with infection prevention procedures, and antimicrobial stewardship programs will be required to limit the spread of colistinresistant <em>K. pneumoniae</em>.