ReviewAfrican journal of laboratory medicine2026
The colistin resistance pandemic: A dual threat from plasmid-encoded mobilised colistin resistance genes and chromosomal mutations.
Review in African journal of laboratory medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Colistin remains a critical last-line therapeutic option against multidrug-resistant Gram-negative infections; but its utility is threatened increasingly by the global spread resistance determinants. Resistance emerges through two principal genetic pathways: horizontal transmission of Aim: To compare plasmid-mediated and chromosomal colistin resistance mechanisms and examine their clinical significance, epidemiological implications, diagnostic challenges, and surveillance barriers within a One Health framework. Methods: For this narrative, non-systematic review, searches were conducted in PubMed, MEDLINE, Web of Science, Scopus and African Journals Online (AJOL) to identify studies on colistin resistance, its emergence, clinical implications, and related surveillance and diagnostic barriers. Results: Several genetic determinants influence colistin susceptibility; notably, Conclusion: Although surveillance-driven stewardship may mitigate resistance trends, its effectiveness is constrained by the convergence of colistin and carbapenem resistance, increasing the risk of pan-drug-resistant infections. Rapid field-deployable diagnostics and harmonised global surveillance systems that consider the distinct evolutionary trajectories of plasmid-mediated and chromosomal resistance remain urgently needed. What this study adds: This review highlights the contrasting evolutionary pathways of plasmid-mediated and chromosomal colistin resistance and emphasises the importance of integrated surveillance, diagnostics, and stewardship strategies within a One Health approach.
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