Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Antimicrobials

Reviving colistin

Nature Reviews Microbiology (2023)Cite this article

Subjects

Infections caused by multidrug-resistant bacteria are a major threat to global health. Antibiotic-resistant Gram-negative pathogens are particularly difficult to treat, often requiring the use of last-resort antibiotics like polymyxins. These antibiotics, including colistin, target the lipid A component of the lipopolysaccharide present on the bacterial outer membrane and the cytoplasmic membrane, leading to membrane destabilization and rupture and cell lysis. Unfortunately, bacteria can develop resistance to polymyxins by altering the lipid A through different mechanisms: chromosomal mutations in regulatory genes or plasmid-mediated acquisition of the colistin resistance gene mcr-1, which can affect the function of transferase enzymes involved in lipid A modification. The rise in resistance to polymyxins and their subsequent reduced therapeutic efficacy is worrisome, and combination therapies where colistin synergizes with a bioactive partner compound seem promising. In this study, Carfrae et al. demonstrate that inhibition of biotin or fatty acid biosynthesis restores colistin bactericidal activity in vitro and in vivo against Gram-negative bacteria and prevents colistin resistance emergence.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

References

Original article

Download references

Author information

Authors and Affiliations

  1. Nature Reviews Microbiology http://www.nature.com/nrmicro/

    Agustina Taglialegna

Authors
  1. Agustina Taglialegna
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Agustina Taglialegna.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Taglialegna, A. Reviving colistin. Nat Rev Microbiol (2023). https://doi.org/10.1038/s41579-023-00907-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1038/s41579-023-00907-0

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing