Colistin

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Resistance

  • Conferred by alterations in lipid A, either reducing its charge or eliminating it altogether
  • May be chromosomal (e.g. pmrC, pmrF, pmrAB, lpxA, lpxC, lpxD, OprH) or plasmid-mediated (e.g. mcr-1 gene)
  • Often seen in Proteus, Providencia, Serratia, Morganella, Burkholderia cepacia, Neisseria, and Burcella