Journal of global antimicrobial resistance最新文献

{"title":"Understanding the evolution of macrolides resistance: A mini review","authors":"","doi":"10.1016/j.jgar.2024.07.016","DOIUrl":"10.1016/j.jgar.2024.07.016","url":null,"abstract":"<div><h3>Background</h3><p>Macrolides inhibit the growth of bacterial cells by preventing the elongation of polypeptides during protein biosynthesis and include natural, synthetic, and semi-synthetic products. Elongation prevention occurs by blocking the passage of the polypeptide chain as the macrolides bind at the nascent peptide exit tunnel.</p></div><div><h3>Objective</h3><p>Recent data of ribosome profiling via ribo-seq further proves that, other than blocking the polypeptide chain, macrolides are also able to affect the synthesis of individual proteins. Thus, this shows that the mode of action of macrolides is more complex than we initially thought. Since the discovery of macrolides in the 1950s, they have been widely used in veterinary practice, agriculture, and medicine. Due to misuse and overuse of antibiotics, bacteria have acquired resistance against them. Hence, it is of utmost importance for us to fully understand the mode of action of macrolides as well as the mechanisms of resistance against macrolides in order to mitigate antibiotic-resistance issues.</p></div><div><h3>Results</h3><p>Chemical modifications can be performed to improve macrolide potency if we have a better understanding of their mode of action. Furthermore, a complete and detailed understanding of the mode of action of macrolides has remained vague, as new findings have challenged theories that are already in existence—due to this obscurity, research into macrolide modes of action continues to this day.</p></div><div><h3>Conclusion</h3><p>In this review, we present an overview of macrolide antibiotics, with an emphasis on the latest knowledge regarding the mode of action of macrolides as well as the mechanisms of resistance employed by bacteria against macrolides.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001474/pdfft?md5=08cc73f5ea14a81dd49aeb2599265129&pid=1-s2.0-S2213716524001474-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular epidemiology of multidrug-resistant Acinetobacter baumannii isolates from a hospital in Nepal","authors":"","doi":"10.1016/j.jgar.2024.07.017","DOIUrl":"10.1016/j.jgar.2024.07.017","url":null,"abstract":"<div><h3>Objectives</h3><p>The emergence of multidrug-resistant (MDR) <em>Acinetobacter baumannii</em> has become a serious worldwide medical problem. This study was designed to clarify the genetic and epidemiological properties of MDR <em>A. baumannii</em> clinical isolates.</p></div><div><h3>Methods</h3><p>A total of 66 MDR <em>A. baumannii</em> isolates were obtained from 66 inpatients between May 2019 and February 2020 in a university hospital in Nepal. Whole genomes of these isolates were sequenced using next-generation sequencing. Phylogenetic trees were constructed from single nucleotide polymorphism concatemers. Multilocus sequence typing (MLST) and clonal complex (CC) analysis were conducted, and drug-resistance genes were identified.</p></div><div><h3>Results</h3><p>Of the 66 isolates, 26 harboured a gene encoding NDM-type metallo-β-lactamase, and 55 harboured a gene encoding the 16S rRNA methyltransferase, ArmA. All isolates had point mutations in the quinolone-resistance-determining regions of <em>gyrA</em> and <em>parC</em>. Phylogenetic analysis showed that 55 isolates harboured <em>armA,</em> 26 harboured <em>bla</em>_NDM-1, and14 harboured <em>bla</em>_PER-7. Multilocus sequence typing and CC analysis revealed that 34 isolates belonged to CC2 (ST2), 10 to CC1 (nine ST1 and one ST623), and eight to CC149 (ST149). Compared to our previous study on MDR <em>A. baumannii</em> in Nepal in 2012, the isolation rate of CC2 increased, whereas that of CC149 decreased between 2012 and 2020.</p></div><div><h3>Conclusions</h3><p>This study indicates that MDR <em>A. baumannii</em> producing carbapenemase and 16S rRNA methyltransferase, with high resistance to carbapenems and/or aminoglycosides, are spreading in medical settings in Nepal. The genetic backgrounds of MDR <em>A. baumannii</em> isolates have shifted to international clone 2 over several years.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001486/pdfft?md5=1bc0b27244ef6b7d306bb9db8be7b3c6&pid=1-s2.0-S2213716524001486-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbapenemase-producing Klebsiella quasipneumoniae ST688 (NDM-1) and Klebsiella michiganensis ST40 (KPC-2) in food destined for hospitalized patients","authors":"","doi":"10.1016/j.jgar.2024.07.015","DOIUrl":"10.1016/j.jgar.2024.07.015","url":null,"abstract":"<div><h3>Objectives</h3><p><em>Klebsiella</em> spp. are leading causes of nosocomial infections. Their ability to harbour antimicrobial resistance genes makes them an important public health threat. This study aimed to report the genomic background of carbapenemase-producing <em>Klebsiella quasipneumoniae</em> (HV55B) and <em>Klebsiella michiganensis</em> (HV55D) strains isolated from fresh vegetables destined for hospitalized inpatients.</p></div><div><h3>Methods</h3><p>Microbiological and molecular methods were used to isolate and identify the strains, which were submitted to the antimicrobial susceptibility test and pH tolerance assays. Whole genome sequencing was performed on MiSeq and NextSeq platforms, and online available tools were applied to bioinformatic analysis of clinically relevant information.</p></div><div><h3>Results</h3><p>Both isolates were considered multidrug-resistant and tolerated pH ≥ 4 for 24 h. HV55B belonged to sequence type (ST) ST668, and presented a broad resistome and plasmids from four incompatibility groups. HV55D belonged to ST40. Both strains HV55B and HV55D were genetically close to isolates responsible for human infections around the world, which stands for the plausibility of such bacteria to cause disease in patients of the studied institution.</p></div><div><h3>Conclusions</h3><p>Our results confirm the presence of carbapenemase-producing <em>Klebsiella</em> spp. in fresh foodstuffs intended for hospitalized inpatients’ consumption. The genomes characterized here also provide clinically and genomically relevant information to forthcoming epidemiological surveillance studies.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001462/pdfft?md5=e4fcf770235a8f6acbee2b92da1ecd55&pid=1-s2.0-S2213716524001462-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased biofilm-associated carbapenem-resistant Acinetobacter calcoaceticus–baumannii complex infections among hospitalised patients in Kathmandu Model Hospital, Nepal","authors":"","doi":"10.1016/j.jgar.2024.07.012","DOIUrl":"10.1016/j.jgar.2024.07.012","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001437/pdfft?md5=4d5f101ffadf26217c2ab21966199665&pid=1-s2.0-S2213716524001437-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UPC2 mutations and development of azole resistance in Candida albicans hospital isolates from Lebanon","authors":"","doi":"10.1016/j.jgar.2024.07.010","DOIUrl":"10.1016/j.jgar.2024.07.010","url":null,"abstract":"<div><h3>Objectives</h3><p>This study evaluated the role of Upc2 in the development of azole resistance in <em>Candida albicans</em> isolates from Lebanese hospitalized patients and determined a correlation between resistance and virulence.</p></div><div><h3>Methods</h3><p>The <em>UPC2</em> gene which codes for an ergosterol biosynthesis regulator was sequenced and analysed in two azole-resistant and one azole-susceptible <em>C. albicans</em> isolates. An amino acid substitution screening was carried out on Upc2 with a focus on its ligand binding domain (LBD) known to interact with ergosterol. Then, Upc2 protein secondary structure prediction and homology modelling were conducted, followed by total plasma membrane ergosterol and cell wall chitin quantifications. For virulence, mouse models of systemic infection were generated and an agar adhesion and invasion test was performed.</p></div><div><h3>Results</h3><p>Azole-resistant isolates harboured novel amino acid substitutions in the LBD of Upc2 and changes in protein secondary structures were observed. In addition, these isolates exhibited a significant increase in plasma membrane ergosterol content. Resistance and virulence were inversely correlated while increased cell wall chitin concentration does not seem to be linked to resistance since even though we observed an increase in chitin concentration, it was not statistically significant.</p></div><div><h3>Conclusions</h3><p>The azole-resistant <em>C. albicans</em> isolates harboured novel amino acid substitutions in the LBD of Upc2 which are speculated to induce an increase in plasma membrane ergosterol content, preventing the binding of azoles to their target, resulting in resistance.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001401/pdfft?md5=732851a1ab22b57538a82367d3fb8c75&pid=1-s2.0-S2213716524001401-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological pattern and genomic insights into multidrug-resistant ST491 Acinetobacter baumannii BD20 isolated from an infected wound in Bangladesh: Concerning co-occurrence of three classes of beta lactamase genes","authors":"","doi":"10.1016/j.jgar.2024.07.009","DOIUrl":"10.1016/j.jgar.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><p>Multidrug-resistant (MDR) <em>Acinetobacter baumannii</em> is a major issue within healthcare facilities in Bangladesh due to its frequent association with hospital-acquired infections. In this study we report on a carbapenem-resistant draft genome sequence of an <em>A. baumannii</em> BD20 sample isolated from an infected wound in Bangladesh.</p></div><div><h3>Methods</h3><p><em>A. baumannii</em> BD20 was isolated from an infected burn wound. Whole-genome sequencing was carried out and annotated using PGAP and Prokka. Sequence type, antimicrobial resistance genes, virulence factor genes, and metal resistance genes were investigated. Core genome multilocus sequence typing–based phylogenomic analysis between <em>A. baumannii</em> BD20 and 213 <em>A. baumannii</em> strains retrieved from the NCBI GenBank database was performed using the BacWGSTdb 2.0 server.</p></div><div><h3>Results</h3><p><em>A. baumannii</em> BD20 (MLST 491) was resistant to all the antibiotics tested, except for colistin and polymyxin B. Along with many other antibiotic resistance genes, the isolate harbored three classes of beta lactamase–producing genes: <em>bla</em>_GES-11 (class A), <em>bla</em>_OXA-69 (class D), <em>bla</em>_ADC-10 (class C), and <em>bla</em>_ADC-11 (class C). Additionally, the strain carried several virulence genes and metal resistance determinants, which may contribute to its increased virulence. Core genome MLST–based phylogenomic analysis revealed that <em>A. baumannii</em> BD20 was closely related to another ST491 strain isolated from Singapore.</p></div><div><h3>Conclusions</h3><p>The findings of this study underscore the growing challenge of MDR <em>A. baumannii</em>, emphasizing the need for vigilant surveillance and infection-control measures in healthcare settings in order to address these emerging threats effectively.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001395/pdfft?md5=c90865ae9f0839867ab7ef6c308f03b5&pid=1-s2.0-S2213716524001395-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial susceptibilities, resistance mechanisms and molecular characteristics of toxigenic Clostridioides difficile isolates in a large teaching hospital in Chongqing, China","authors":"","doi":"10.1016/j.jgar.2024.07.006","DOIUrl":"10.1016/j.jgar.2024.07.006","url":null,"abstract":"<div><h3>Objectives</h3><p><em>Clostridioides difficile</em> ranks among the primary sources of healthcare-related infections and diarrhoea in numerous nations. We evaluated the drug susceptibility and resistance mechanisms of <em>C. difficile</em> isolates from a hospital in Chongqing, China, and identified resistance rates and resistance mechanisms that differed from previous findings.</p></div><div><h3>Methods</h3><p>The toxin genes and drug resistance genes of clinical strains were detected using Polymerase Chain Reaction (PCR), and these strains were subjected to Multilocus Sequence Typing (MLST). The agar dilution technique was employed for assessing susceptibility of antibiotics. Clinical data collection was completed through a review of electronic medical records.</p></div><div><h3>Results</h3><p>A total of 67 strains of toxin-producing <em>C. difficile</em> were detected. All <em>C. difficile</em> isolates demonstrated susceptibility to both metronidazole and vancomycin. However, resistance was observed in 8.95%, 16.42%, 56.72%, 56.72%, 31.34% and 5.97% of the isolates for tigecycline, tetracycline, clindamycin, erythromycin, moxifloxacin and rifampin, respectively. Among the strains with toxin genotypes A + B + CDT - and belonging to the ST3, six strains exhibited reduced susceptibility to tigecycline (MIC=0.5mg/L) and tetracycline (MIC=8mg/L). The <em>tetA(P)</em> and <em>tetB(P)</em> genes were present in these six strains, but were absent in tetracycline-resistant strains. Resistance genes (<em>ermB, tetM, tetA(P)</em> and <em>tetB(P)</em>) and mutations (in <em>gyrA, gyrB</em>, and <em>rpoB</em>) were identified in resistant strains.</p></div><div><h3>Conclusions</h3><p>In contrast to prior studies, we found higher proportions of ST3 isolates with decreased tigecycline sensitivity, sharing similar resistance patterns and resistance genes. In the resistance process of tigecycline and tetracycline, the <em>tetA(P)</em> and <em>tetB(P)</em> genes may play a weak role.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001383/pdfft?md5=64886bf1fb49bd1132f375290153d0a9&pid=1-s2.0-S2213716524001383-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clonal dissemination of Klebsiella pneumoniae carrying blaOXA-48 gene in a central Italy hospital","authors":"","doi":"10.1016/j.jgar.2024.07.004","DOIUrl":"10.1016/j.jgar.2024.07.004","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001358/pdfft?md5=ff5dc34d77329d1d29466e7c8cfe71de&pid=1-s2.0-S2213716524001358-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for mortality in Acinetobacter baumannii bloodstream infections and development of a predictive mortality model","authors":"","doi":"10.1016/j.jgar.2024.06.010","DOIUrl":"10.1016/j.jgar.2024.06.010","url":null,"abstract":"<div><h3>Objectives</h3><p><em>Acinetobacter baumannii</em> (<em>A. baumannii</em>) nosocomial infections represent a serious hazard to public health, given high mortality rates and rapid spread of multidrug-resistance. The primary outcome of this study was to evaluate predictors of 14- and 30-d mortality in bloodstream infections (BSIs) due to both carbapenem-resistant and carbapenem-sensitive <em>Acinetobacter.</em> Secondary end points were to identify risk factors for BSIs due to carbapenem-resistant <em>A. baumannii</em> (CRAB) and to develop a predictive model for mortality in CRAB-related BSIs.</p></div><div><h3>Methods</h3><p>Between 2019 and 2023, all consecutive hospitalized adult patients with bacteraemia due to <em>A. baumannii</em> were retrospectively enrolled at a single-centre<em>.</em></p></div><div><h3>Results</h3><p>One hundred twenty-six episodes of BSI caused by <em>A. baumannii</em> were recorded, 89.7% of which were due to CRAB. Recent burn injuries, older age, previous CRAB colonization, and antibiotics exposure were identified as risk factors for acquiring CRAB BSI. Overall, 14-d mortality was observed in 26.1% of the patients and 30-d mortality in 30.9% of the patients. On multivariate analysis, the Sequential Organ Failure Assessment (SOFA) score was associated with both 14- and 30-d mortality, whereas burn injuries correlated with 30-d survival. Concurrent coronavirus disease (COVID) was associated with mortality, although not reaching statistical figures. No major impact of receiving appropriate treatment was observed. Based on these findings, a multivariable model to predict mortality among patients with CRAB BSI was built and internally validated.</p></div><div><h3>Conclusions</h3><p><em>A. baumannii</em> BSIs are characterized by poor outcomes and limited therapeutic options. This study aimed to assist physicians in prompt identification of patients who are at greater risk of death, contributing to more informed clinical decision making.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001255/pdfft?md5=85f8dfbe57eb332ca4389320273c36ca&pid=1-s2.0-S2213716524001255-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and structural basis of colistin resistance in Klebsiella pneumoniae: Unravelling the molecular mechanisms","authors":"","doi":"10.1016/j.jgar.2024.06.019","DOIUrl":"10.1016/j.jgar.2024.06.019","url":null,"abstract":"<div><h3>Objective</h3><p>Antimicrobial resistance (AMR), together with multidrug resistance (MDR), mainly among Gram-negative bacteria, has been on the rise. Colistin (polymyxin E) remains one of the primary available last resorts to treat infections caused by MDR bacteria during the rapid emergence of global resistance. As the exact mechanism of bacterial resistance to colistin remains undetermined, this study warranted elucidation of the underlying mechanisms of colistin resistance and heteroresistance among carbapenem-resistant <em>Klebsiella pneumoniae</em> isolates.</p></div><div><h3>Methods</h3><p>Molecular analysis was carried out on the resistant isolates using a genome-wide characterisation approach, as well as MALDI-TOF mass spectrometry, to identify lipid A.</p></div><div><h3>Results</h3><p>Among the 32 carbapenem-resistant <em>K. pneumoniae</em> isolates, several isolates showed resistance and intermediate resistance to colistin. The seven isolates with intermediate resistance exhibited the “skip-well” phenomenon, attributed to the presence of resistant subpopulations. The three isolates with full resistance to colistin showed ions using MALDI-TOF mass spectrometry at <em>m/z</em> of 1840 and 1824 representing bisphosphorylated and hexa-acylated lipid A, respectively, with or without hydroxylation at position C’-2 of the fatty acyl chain. Studying the genetic environment of <em>mgrB</em> locus revealed the presence of two insertion sequences that disrupted the <em>mgrB</em> locus in the three colistin-resistant isolates: IS1R and IS903B.</p></div><div><h3>Conclusions</h3><p>Our findings show that colistin resistance/heteroresistance was inducible with mutations in chromosomal regulatory networks controlling the lipid A moiety and insertion sequences disrupting the <em>mgrB</em> gene, leading to elevated minimum inhibitory concentration values and treatment failure. Different treatment strategies should be employed to avoid colistin heteroresistance-linked treatment failures, mainly through combination therapy using colistin with carbapenems, aminoglycosides, or tigecycline.</p></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001280/pdfft?md5=cd915c9fadd273bed6ecafe07b38089b&pid=1-s2.0-S2213716524001280-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}