Colistin Resistance: critical review of the literature

Introduction: with the emergence of nosocomial pathogens and the emergence ofmultidrug resistant agents, repeated and continuous studies on changes in resistancepatterns of clinic isolated bacteria seem necessary. colistin sulfate is known to be the lastline of treatment against the different range of antibiotic resistance. while recent evidencesshow emergence of the colistin resistance that we are going to review here.methods: a critical review of the literature.results: colistin as a member of earlier classes of antibiotics was still working againstextended-spectrum beta-lactamase -producing bacteria in last decades. this feature of thecolistin was affiliated with its infrequent use due to fear of its medical adverse events.meanwhile, recent reports indicate appearance of the colistin resistance in e. coli,acinetobacter baumannii and klebsiella pneumoniae isolates. sets of different genes inrelation to the colistin resistance are proposed in literature. efflux pumps might also playimportant role in appearance of these resistant strains.conclusion: when any other antibiotic does not work, colistin is use it as the last effectivebead in treating patients. because colistin is used in the last line of treatment, increasingresistance to it is a wake-up call for health systems.