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Review
. 2021 Aug 4;11(1):1962781.
doi: 10.1080/20008686.2021.1962781. eCollection 2021.

Is Africa ready for mobile colistin resistance threat?

Madubuike Umunna Anyanwu  1 , Ishmael Festus Jaja  2   3 , James Wabwire Oguttu  4 , Chinwe Juliana Jaja  3 , Kennedy Foinkfu Chah  1 , Vincent Shodeinde Shoyinka  1
Affiliations
Review

Is Africa ready for mobile colistin resistance threat?

Madubuike Umunna Anyanwu et al. Infect Ecol Epidemiol. .

Abstract

Antimicrobial resistance is a growing public health problem and a threat to effective treatment and prevention of an array of infections caused by bacteria. Africa is already faced with many socio-economic and health crises. Many countries in Africa can seldom boast of a standardized health care facility comparable to those in developed countries. Yet, the non-therapeutic use of COL has been banned in developed countries. However, in Africa, except for South Africa, COL is an over-the-counter (OTC) medication sold and dispensed by non-professionals/without a veterinarian's supervision. The ban of non-therapeutic COL in developed countries has proven to reduce the development of mobile colistin resistance (MCR) in humans and animals. The unregulated use of COL has been proven to select pathogenic and commensal bacteria resistance. A transmissible plasmid-mediated colistin determinant, mobile COL resistance (mcr) gene, which is rapidly transferred/acquired horizontally or laterally intra/inter-species/genera, has been reported. A highly promiscuous mobile genetic element like plasmids containing transposons, insertion sequences, and integrons aid the carriage/rapid transfer and acquisition of these mcr genes. Hence, we highlight the danger posed by escalating colistin (COL) resistance in the continent and the impetus to halt the indiscriminate and non-therapeutic use of COL to protect public health.

Keywords: Africa; antibiotic resistance; colistin; emerging threat; mcr.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Mobile colistin resistance mechanisms in diverse ecosystems in Africa. This map was created using an online service (https://mapchart.net/)
See this image and copyright information in PMC

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