The prevalence, diagnosis, and dissemination of mcr-1 in colistin resistance: Progress and challenge

Considered as the last defense line against Gram-negative bacteria, colistin is particularly effective against multiple drug-resistant bacteria such as multi-drug resistance (MDR) and carbapenem-resistant Enterobacteriaceae (CRE). However, since the plasmid-mediated mobile colistin resistance-1 (mcr-1) was first reported in China in 2015, it has been widely detected from humans, animals, and the environment across 47 countries/regions worldwide by 2019, which has attracted the attention of the World Health Organization and global government departments, who formulated emergency strategies and interventions to contain its emergence and spread. At present, three kinds of colistin for clinical injection have been adopted in clinic in China. Due to drug pressure screening, the risk with Gram-negative bacteria developing resistance to colistin may corresponding increase. Therefore, rapid, accurate and sensitive detection methods are particularly needed. This review summarizes the prevalence of mcr-1, in addition to a diverse assortment of different detection techniques of colistin resistance, and analyzes the application scenarios, advantages, and challenges of different technologies, in order to provide a scientific evidence-based proof for the rapid detection of colistin resistance.