ArticleScientific reports2022
High prevalence of mgrB-mediated colistin resistance among carbapenem-resistant Klebsiella pneumoniae is associated with biofilm formation, and can be overcome by colistin-EDTA combination therapy.
Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Guts of healthy humans, livestock, and pets harbor critical-priority and high-risk Escherichia coli clones.Epidemiology and health · 2025Pooled it
- Global prevalence of mutation in theFrontiers in microbiology · 2024Pooled it
- Biofilm-Mediated Antimicrobial Resistance in PediatricAntibiotics (Basel, Switzerland) · 2026Review
- Antimicrobial Effect of Spices and Their Phytochemicals: A Novel Approach to Overcoming Antibiotic Resistance.MedComm · 2026Review
- Article
- Emerging therapeutic drug targets in amino acid and protein biosynthesis pathways against ESKAPE and non-ESKAPE pathogens: a comprehensive review.Archives of microbiology · 2026Review
- Colistin Resistance in Gram-Negative Bacteria: Mechanisms, Transmission, and Novel Intervention Strategies.Microorganisms · 2026Review
- An Investigation of Colistin Heteroresistance inBioMed research international · 2026Article
- tesG expression as a potential clinical biomarker for chronic Pseudomonas aeruginosa pulmonary biofilm infections.BMC medicine · 2025Article
- Increasing polymyxin resistance in clinical carbapenem-resistant Klebsiella pneumoniae strains in China between 2000 and 2023.Communications medicine · 2025Article
- Clinical, antibiotic resistance features, and treatment outcomes of Vietnamese patients with community-acquired sepsis caused byIJID regions · 2025Article
- The First Report ofMicroorganisms · 2024Article
- Phage cocktail amikacin combination as a potential therapy for bacteremia associated with carbapenemase producing colistin resistant Klebsiella pneumoniae.Scientific reports · 2024Article
- Co-existence of antibiotic resistance and virulence factors in carbapenem resistant Klebsiella pneumoniae clinical isolates from Alexandria, Egypt.BMC microbiology · 2024Article
- First detection of multidrug-resistant and toxigenic Pasteurella aerogenes in sow vaginal discharge: a novel threat to swine health in Thailand.Scientific reports · 2024Article
- The effect of combinations of a glyphosate-based herbicide with various clinically used antibiotics on phenotypic traits of Gram-negative species from the ESKAPEE group.Scientific reports · 2024Article
- Solithromycin in Combination with Other Antimicrobial Agents Against the Carbapenem ResistantIndian journal of microbiology · 2024Article
- Evolution of Antimicrobial Resistance inAntibiotics (Basel, Switzerland) · 2024Article
- Respiratory carriage of hypervirulent Klebsiella pneumoniae by indigenous populations of Malaysia.BMC genomics · 2024Article
- Enhancing colistin efficacy against Salmonella infections with a quinazoline-based dual therapeutic strategy.Scientific reports · 2024Article
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Authors and funding
29 authors at 12 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The global prevalence of colistin-resistant Klebsiella pneumoniae (ColRkp) facilitated by chromosomal and plasmid-mediated Ara4N or PEtN-remodeled LPS alterations has steadily increased with increased colistin usage for treating carbapenem-resistant K. pneumoniae (CRkp). Our study demonstrated the rising trend of ColRkp showing extensively and pandrug-resistant characteristics among CRkp, with a prevalence of 28.5%, which was mediated by chromosomal mgrB, pmrB, or phoQ mutations (91.5%), and plasmid-mediated mcr-1.1, mcr-8.1, mcr-8.2 alone or in conjunction with R256G PmrB (8.5%). Several genetic alterations in mgrB (85.1%) with increased expressions of Ara4N-related phoPQ and pmrK were critical for establishing colistin resistance in our isolates. In this study, we discovered the significant associations between extensively drug-resistant bacteria (XDR) and pandrug-resistant bacteria (PDR) ColRkp in terms of moderate, weak or no biofilm-producing abilities, and altered expressions of virulence factors. These ColRkp would therefore be very challenging to treat, emphasizing for innovative therapy to combat these infections. Regardless of the underlying colistin-resistant mechanisms, colistin-EDTA combination therapy in this study produced potent synergistic effects in both in vitro and in vivo murine bacteremia, with no ColRkp regrowth and improved animal survival, implying the significance of colistin-EDTA combination therapy as systemic therapy for unlocking colistin resistance in ColRkp-associated bacteremia.
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