Abstract
Colistin resistance involving Gram-negative bacilli
infections is a challenge for
health institutions around of the world.
Carbapenem-resistance among these isolates makes
colistin the last
therapeutic option for this
treatment.
Colistin resistance among
Enterobacteriaceae,
Acinetobacter spp., and
Pseudomonas spp. was evaluated between 2010 and 2014 years, at
Hospital das Clínicas, São Paulo,
Brazil. Over five years 1346 (4.0%)
colistin resistant Gram-negative bacilli were evaluated.
Enterobacteriaceae was the most frequent (86.1%) pathogen isolated, followed by
Acinetobacter spp. (7.6%), and
Pseudomonas spp. (6.3%). By temporal
analysis there was a trend for an increase of
colistin resistance among
Enterobacteriaceae, but not among non-fermentative isolates. Among 1346
colistin resistant isolates,
carbapenem susceptibility was observed in 21.5%.
Colistin resistance in our
hospital has been alarmingly increased among
Klebsiella pneumoniae isolates in both KPC positive and negative, thus becoming a
therapeutic problem.