Colistin Resistance: Critical Review of The literature

Background: With the emergence of nosocomial pathogens and the emergence of Multidrug Resistant Microorganisms, continuous and intensive studies on changes in resistance patterns of clinic isolated bacteria seem necessary. Colistin sulfate is known to be the last line of treatment against the different range of antibiotic resistance. Recent evidences confirm emergence of the colistin resistance in various bacteria which should be examined and considered. Methods: A critical review of the literature.  Results: colistin as a member of earlier classis of antibiotics was still working against extended spectrum beta-lactamase-producing bacteria in last decades. This feature of the colistin was affiliated to 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 in relation to the colistin resistance are proposed in literature. Efflux pumps might also play important role in appearance of these resistant strains. Conclusion: When any other antibiotic does not work, Colistin is used as the last effective and Available treatment option for patients in treating patients. Because colistin is used in the last line of treatment, increasing resistance to it is a wake-up call for health systems.