Zidan, Hiba Hamed (2026) Molecular Detection and Epidemiological Distribution of Colistin-Resistance Genes among Gram-Negative Clinical Isolates in Iraq: A Narrative Review. World of Medicine : Journal of Biomedical Sciences, 3 (10). ISSN 2960-9356

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Abstract

Colistin which is also known as polymyxin E is one of the last-resort antimicrobial agents for the treatment of severe infections caused by multidrug-resistant Gram-negative bacteria, particularly carbapenem resistant Enterobacterales (CRE), Acinetobacter baumannii (AB) and Pseudomonas aeruginosa. However, dissemination of colistin resistance has posed a significant challenge to the importance of this important last line antibiotic. Colistin resistance can occur from chromosomal mutations that alter lipopolysaccharide modification pathways or through acquisition of transferable plasmid-mediated mcr genes. The detection of mcr-1 and mcr-2 -mcr-10 variants in clinical, animal, food and environmental reservoirs is a major cause for concern as these genes can confer horizontal transmission of colistin resistance to bacterial populations. Iraq is an important epidemiological setting where antimicrobial resistance related to common use of antibiotics, low levels of antimicrobial stewardship, healthcare-associated transmission, poor surveillance and human-animal-environment interactions are combined. This narrative review collates the state-of-the-art knowledge regarding the molecular mechanisms underpinning colistin resistance, with a specific focus on plasmidborne mcr genes and mutational chromosomally encoded determinants among priority Gram-negative pathogens. This article also evaluates the evidence concerning the prevalence and epidemiological distribution of colistin-resistance genes among clinical isolates in Iraq, compares molecular detection methods for their identification, and discusses the public-health and clinical relevance of its spread. Lastly, it emphasizes the major research gaps such as integrated surveillance, standardized molecular diagnostics or rational use of colistin and infection-control measures - necessary components for limiting the emergence and spread of colistin-resistant bacteria in Iraq using a One Health Approach.

Item Type:	Article
Uncontrolled Keywords:	Colistin resistance, mcr genes, Gram-negative bacteria, molecular detection, clinical isolates, antimicrobial resistance, Iraq, epidemiology
Subjects:	H Social Sciences
Depositing User:	admin eprints
Date Deposited:	22 Oct 2026 01:36
Last Modified:	22 Oct 2026 01:36
URI:	http://eprints.umsida.ac.id/id/eprint/17235

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