SynthesisAnnals of clinical microbiology and antimicrobials2025
Prevalence, trends, and molecular insights into colistin resistance among gram-negative bacteria in Egypt: a systematic review and meta-analysis.
Synthesis in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- "Uropathogens and antimicrobial susceptibility patterns in urosepsis patients at kafr el sheikh University hospital: a cross-sectional study".Scientific reports · 2026Article
- Antibiotic resistance mechanisms and global resistance patterns of Pseudomonas aeruginosa in microbial keratitis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- WGS reveals high-risk clones of Pseudomonas aeruginosa harbouring extensive antimicrobial and predicted anti-phage defense systems recovered from diabetic foot ulcer patients in Egypt.BMC microbiology · 2026Article
- First report of the mcr-1 gene in colistin-resistant Klebsiella pneumoniae in a tertiary care hospital in Tunisia.BMC infectious diseases · 2026Article
- Expanding Threat of Carbapenemase-ProducingbioRxiv : the preprint server for biology · 2026Article
- Patterns of occurrence and antimicrobial resistance of Escherichia coli and Staphylococcus aureus in public playgrounds.Scientific reports · 2026Article
- Analysis of Antibiotic Consumption Trends and Pathogens' Epidemiological Profile Within a Multidisciplinary Clinical Hospital from Romania.Antibiotics (Basel, Switzerland) · 2026Article
- Epidemiology, resistance profiles, and risk factors of multidrug-resistant Klebsiella pneumoniae: experience from a low- and middle-income country.BMC infectious diseases · 2025Article
- Colistin resistance in the era of antimicrobial resistance: challenges and strategic countermeasures.Folia microbiologica · 2025Review
- The Gut Microbiome and Colistin Resistance: A Hidden Driver of Antimicrobial Failure.International journal of molecular sciences · 2025Review
- Prevalence of Antimicrobial Drug-resistant Bacteria in Intensive Care Unit Environment and Its Impact on Clinical Infections in Bangladesh.Euroasian journal of hepato-gastroenterologyArticle
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6 authors.
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Abstract
backgroundThis study examines colistin resistance in Gram-negative bacteria in Egypt, analyzing prevalence, trends, geographic variations, colistin-carbapenem resistance correlation, and mcr-mediated plasmid resistance.
methodsWe conducted a systematic search of articles published between 2014 and 2024 that reported on colistin or mcr-mediated resistance in Gram-negative bacteria isolated from human infections in Egypt, with clearly defined susceptibility testing methods. A random-effects meta-analysis was conducted to estimate colistin resistance prevalence based on broth microdilution (BMD) findings, the gold standard method. To explore the influence of study-level factors-including alternative susceptibility testing methods-a multivariate meta-regression analysis was performed. The results of the meta-regression are reported as regression coefficients (β), representing the difference in colistin resistance, expressed in percentage points. All statistical analyses were conducted using R software.
resultsThis analysis included 55 studies. Based on BMD susceptibility testing, colistin resistance was observed in 9% of all recovered Gram-negative isolates (95% CI: 6-14%) and was significantly higher among carbapenem-resistant isolates (31%, 95% CI: 25-38%), with p < 0.001. Multivariate meta-regression analysis further confirmed that colistin resistance was significantly higher in carbapenem-resistant isolates compared to the total recovered isolates (β = 9.8% points, p = 0.001). Additionally, colistin resistance has significantly increased over time, with a β = 1.8% points per year (p = 0.001). The use of the VITEK 2 system was associated with lower detected colistin resistance compared to BMD (β = -7.0, p = 0.02). Geographically, resistance rates were higher in Upper Egypt (β = 9.3, p = 0.04). Regarding mcr plasmid-mediated resistance, mcr-1 was the most prevalent resistance gene, particularly in E. coli. In contrast, mcr-2 was rare, detected sporadically in K. pneumoniae and P. aeruginosa.
conclusionIn Egypt, BMD testing identified colistin resistance in 9% of Gram-negative bacteria, increasing to 31% in carbapenem-resistant isolates. This higher resistance in carbapenem-resistant strains suggests stronger selective pressure from frequent colistin use. Additionally, colistin resistance has shown a rising trend over time, likely driven by increased usage and the spread of plasmid-mediated resistance. These findings underscore the urgent need for strict antimicrobial stewardship and alternative therapies to curb resistance evolution.
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