Emergence of Colistin Resistance against Multi-Drug Resistance Microorganisms and its Clinical Outcomes

Abstract

Background: Over the past decade, excessive use of Colistin against multidrug-resistant, Gram-negative bacteria have resulted in the evolution of resistance to Colistin. Objective: To evaluate efficacy of Colistin against multidrug-resistant organisms (MDRO), the emergence of Colistin resistance and its effects on clinical outcomes. Study Design: Retrospective study Place and Duration of Study: King Saud Medical City (KSMC) from 1st October 2015 till 31st January 2016. Methodology: Forty-three patients, resistant to Colistin on blood culture and sensitivity were enrolled. Results: Colistin was not effective at breaking the MDRO. The results revealed no significant impact of Colistin on site of infection such as chest, urinary tract or skin (p=0.612), types of organisms (p=0.629), length of hospital stay and the IV Colistin days (p=0.097 and p=0.166 respectively) in the past 12 months. The positive finding was that more than two third (76.7%) of the ICU patients were alive. Conclusion: Emergence of Multi drug resistance organism is matter of global concern that caused the ineffectiveness of many potent antibiotics and led to the drastic clinical outcomes. Collaboration between medical, paramedical, and administrative staff, with strict implementation of preventive protocol can slow down the velocity of microbial multidrug resistance. Keywords: Multi-drug resistant, Colistin, Outbreak, Intensive care unit, critically ill patients