Resistance to colistin in Klebsiella pneumoniae: A 4.0 strain?

Guido Granata, Nicola Petrosillo

Research output: Contribution to journalReview articlepeer-review


The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gramnegative bacteria a global spread of extended-spectrum beta-lactamases and carbapenemases producing Klebsiella pneumoniae has been observed. Treatment options for multidrug-resistant K. Pneumoniae are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline-resistant K. Pneumoniae is increasing globally. Infection due to colistin-resistant K. Pneumoniae represents an independent risk factor for mortality. Resistance to colistin in K. Pneumoniae may be multifactorial, as it is mediated by chromosomal genes or plasmids. The emergence of transmissible, plasmid-mediated colistin resistance is an alarming finding. The absence of new agents effective against resistant Gram-negative pathogens means that enhanced surveillance, compliance with infection prevention procedures, and antimicrobial stewardship programs will be required to limit the spread of colistin-resistant K. Pneumoniae.

Original languageEnglish
Pages (from-to)69-72
Number of pages4
JournalInfectious Disease Reports
Issue number2
Publication statusPublished - Jan 1 2017


  • Antimicrobial resistance
  • Colistin
  • Klebsiella pneumoniae
  • Plasmid mediated resistance
  • Tigecycline

ASJC Scopus subject areas

  • Infectious Diseases


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