Multidrug Resistance: Emerging Clinical Challenges Andrecent Updates

Multidrug-resistant(MDR)bacteria was discovered as early as 1950s.Transmissible R factors of Enterobacteriaceae received greatest attention, the existence of plasmids were identified which confer antibiotic resistance in many genera. Plasmids also confer resistance to penicillin, chloramphenicol, erythromycin, and number of heavy metals. Multidrug-resistance Gram-negative bacteria pose a great threat to the public health due to the limited treatment options available and lack of newly developed antimicrobials medications.NewDelhimetallo-beta lactamase-1(NDM-1) are detected worldwide.Colistin-Polymyxin E remains one of the lastresort antibiotics for multi resistant bacteria.Colistin in combination with drugs are used to treat P.aeruginosabiofilim infection in lungs of cystic fibrosis patients. The plasmid-borne mcr1 gene has been found to confer resistance to colistin.This plasmid-borne-mcr-1 has been isolated in China, Europe and,UnitedStates.India reported colistin-resistance,particularly in the blood stream infection. Resistance to Polymixins is frequent in the Mediterranean,Southeast Asia(Korea and Singapore).Colistin resistant Acinetobacter baumannii strains also developed resistance to LL-37 compounds and lysozyme. Resistance to carbapenem group of drugs has been reported in many countries. A restrained policy of antibiotic usage will prevent the spread of MDR worldwide.