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Review
. 2024 Jan 4;12(1):101.
doi: 10.3390/microorganisms12010101.

Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Rebeca Siqueira Rubens  1 , Isabel de Souza Andrade Arruda  1 , Rosane Mansan Almeida  1 , Yanna Karla de Medeiros Nóbrega  1 , Maiara Dos Santos Carneiro  2 , Tanise Vendruscolo Dalmolin  1
Affiliations
Review

Challenges in the Detection of Polymyxin Resistance: From Today to the Future

Rebeca Siqueira Rubens et al. Microorganisms. .

Abstract

Antimicrobial resistance is known to be one of the greatest global threats to human health, and is one of the main causes of death worldwide. In this scenario, polymyxins are last-resort antibiotics to treat infections caused by multidrug-resistant bacteria. Currently, the reference test to evaluate the susceptibility of isolates to polymyxins is the broth microdilution method; however, this technique has numerous complications and challenges for use in laboratory routines. Several phenotypic methods have been reported as being promising for implementation in routine diagnostics, including the BMD commercial test, rapid polymyxin NP test, polymyxin elution test, culture medium with polymyxins, and the Polymyxin Drop Test, which require materials for use in routines and must be easy to perform. Furthermore, Sensititre®, molecular tests, MALDI-TOF MS, and Raman spectroscopy present reliable results, but the equipment is not found in most microbiology laboratories. In this context, this review discusses the main laboratory methodologies that allow the detection of resistance to polymyxins, elucidating the challenges and perspectives.

Keywords: Gram-negative bacteria; antimicrobial susceptibility; polymyxin resistance; polymyxins.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main methods for detecting polymyxin susceptibility according to the principle. Created with BioRender.com, accessed on 21 November 2023. BMD: broth microdilution; PCR: polymerase chain reaction; LAMP: loop-mediated isothermal amplification of DNA; MALDI-TOF: matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) mass spectrometry.
See this image and copyright information in PMC

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