Global Emergence of mcr-mediated Colistin Resistance in Gram-negative Bacteria: Focusing the Current Status in India Under One Health Lens

Urmy Biswas; Ripan Biswas; Indranil Samanta; Surojit Das

doi:10.37591/rrjomv.v12i3.3031

Abstract

In the global crisis of antimicrobial resistance (AMR), colistin has been revived as a last resort treatment option for multidrug-resistant (MDR) Gram-negative bacterial infections. Rapid dissemination of mobilized colistin resistance (mcr) genes among Gram-negative bacterial pathogens is alarming the healthcare fraternity throughout the world, especially in developing countries such as India compromises infection prevention practices and reduces colistin efficacy during medical emergencies.. Several developed countries have implemented strict regulations on colistin usage policy in veterinary medicine and conducted continuous epidemiological surveillance on AMR including colistin resistance. On the contrary, the use of colistin in animal husbandry is still ongoing without any invigilation and regulations in most of the world especially the developing countries where the demand for animal foods is high and implementation of regulations is low. Considering the deficit of effective antibiotics due to colistin resistance, it is high time to strictly follow and adhere to antimicrobial stewardships by implementing stringent national policies. Inequality in AMR surveillance across animal-human- environmental interfaces obstacles the reflection of the true global burden of colistin resistance. Unavailability of epidemiological information restricts to development and deploy effective strategies for curbing the AMR towards life-saving antibiotics such as colistin. The issue is immensely prominent in developing countries such as India threatening global health. This review provides current access to the global epidemiology of mcr-mediated colistin resistance among Gram-negative bacterial pathogens by focusing on the situation in India through one health lens.

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