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Prevalence of polymyxin resistance through the food chain, the global crisis

The Journal of Antibiotics volume 75, pages 185–198 (2022)Cite this article

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Abstract

Antimicrobial resistance is one of the vital challenges facing global health today. Multi-drug resistant (MDR) infections are often treated with the narrow-spectrum drugs, colistin (polymyxin E) or polymyxin B, which are last-resort antibiotics for human therapeutics that are effective against Gram-negative bacteria. Unfortunately, resistance to these polymyxins has occurred because of selective pressure caused by the inappropriate use of those antibiotics, especially in farming. The mechanisms of resistance to polymyxins are mediated through intrinsic, mutational, or genetic alteration in chromosomal genes. The mechanism includes the regulatory network controlling chemical modifications of lipid A moiety of lipopolysaccharide, reducing the negative charge of lipid A and its affinity for polymyxins. Additionally, the unique mobile colistin/polymyxin B resistance (mcr) gene reported in Enterobacteriales is responsible for the horizontal dissemination of resistance to polymyxins via the food chain. There is now an urgent need to increase surveillance for detecting resistance to polymyxins. Therefore, this review presents an overview of presently available scientific literature on the mechanism of resistance to polymyxins, with their associated gene variants, evaluation methods, resistance transmission through the food chain via food bacteria, and related risk factors. We further focus on the significant implications of polymyxins usage in India and future views for food safety to preserve polymyxin activity.

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Acknowledgements

Authors thank The Director, Dr Sridevi A Singh, CSIR- Central Food Technological Research Institute, Mysuru, India for facilities and encouragement to write the article. MR would like to thank ICMR, New Delhi for providing ICMR RA fellowship. AM would like to thank DST, New Delhi for the award of WOS-B fellowship. No external funding was used in the preparation of this review article.

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Authors and Affiliations

  1. Department of Microbiology and Fermentation Technology, CSIR- Central Food Technological Research Institute, Mysuru, 570020, India

    Mousumi Ray & Prakash M. Halami

  2. Department of Microbiology, Faculty of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, 570004, India

    Ashwini Manjunath

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MR and PMH produce the idea for the review article; MR and AM performed the literature survey, critically revised and drafted the review article.

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Correspondence to Prakash M. Halami.

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Ray, M., Manjunath, A. & Halami, P.M. Prevalence of polymyxin resistance through the food chain, the global crisis. J Antibiot 75, 185–198 (2022). https://doi.org/10.1038/s41429-022-00502-0

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