Colistin is polycationic and has both hydrophilic and lipophilic moieties. These poly-cationic regions interact with the bacterial outer membrane, by displacing bacterial counter ions in the lipopolysaccharide. Hydrophobic/hydrophillic regions interact with the cytoplasmic membrane just like a detergent, solubilizing the membrane in an aqueous environment. This effect is bactericidal even in an isosmolaric environment.
Resistance to colistin is currently rare, but is described. At present there is no agreement about how to look for colistin resistance. The Société Française de Microbiologie uses a cut off of 2 mg/l, whereas the British Society for Antimicrobial Chemotherapy sets a cutoff of 4 mg/l or less as sensitive, and 8 mg/ml or more as resistant. There are not currently any US standards for measuring colistin sensitivity.
Exceptional (inherently colistin resistant) Gram-negative bacteria:
Brucella; Burkholderia cepacia; Chryseobacterium indologenes; Edwardsiella Elizabethkingia meningoseptica; Francisella tularensis spp.; Gram-negative cocci; Helicobacter pylori; Moraxella catarrhalis; Neisseria gonorrheae and Neisseria meningitidis; Proteus; Providencia; Serratia; Some strains of Stenotrophomonas maltophilia[18]
Gram-negative organisms with variable resistance to colistin: Aeromonas; Vibrio; Prevotella; Fusobacterium
2. Kumarasamy et. al.; Toleman, Mark A; Walsh, Timothy R; Bagaria, Jay; Butt, Fafhana; Balakrishnan, Ravikumar; Chaudhary, Uma; Doumith, Michel et al. (2010). "Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study". The Lancet Infectious Diseases 10 (9): 597–602. doi:10.1016/S1473-3099(10)70143-2. PMC 2933358. PMID 20705517.
3. Vastag, Brian (2012), "NIH Superbug Outbreak Shows Lack of Antibiotics", The Washington Post, Saturday, 25 August 2012; pg A2.
4. Reis AO, Luz DAM, Tognim MCB, Sader HS, and Gales AC (2003). "Polymyxin-Resistant Acinetobacter spp. Isolates: What Is Next?". Emerg Infect Dis 9: 1025–7.
5. a b Towner K J (2008). "Molecular Basis of Antibiotic Resistance in Acinetobacter spp.". Acinetobacter Molecular Biology. Caister Academic Press. ISBN 0-306-43902-6. [http://www.horizonpress.com/acineto.
6. Benifla M, Zucker G, Cohen S and Alkan M (2004). "Successful treatment of Acinetobacter meningitis with intrathecal polymyxin". J Antimicrobial Chemotherapy 54 (1): 290–293. doi:10.1093/jac/dkh289. PMID 15190037.
7. Yagmur et al.,; Esen, F (2006). "Intrathecal colistin for treatment of Pseudomonas aeruginosa ventriculitis: report of a case with successful outcome". Critical Care 10 (6): 428. doi:10.1186/cc5088. PMC 1794456. PMID 17214907.
8. Motaouakkil et al.,; Charra, B; Hachimi, A; Nejmi, H; Benslama, A; Elmdaghri, N; Belabbes, H; Benbachir, M (2006). "Colistin and rifampicin in the treatment of nosocomial infections from multiresistant Acinetobacter baumannii". Journal of Infection 53 (4): 274–278. doi:10.1016/j.jinf.2005.11.019. PMID 16442632.
9. Karakitsos et al.,; Paramythiotou, E; Samonis, G; Karabinis, A (2006). "Is intraventricular colistin an effective and safe treatment for post-surgical ventriculitis in the intensive care unit?". Acta Anaesthesiol Scand. 50 (10): 1309–1310. doi:10.1111/j.1399-6576.2006.01126.x. PMID 17067336.
10. Colomycin injection [Summary of product characteristics]. http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=1590
11. http://www.emea.europa.eu/pdfs/vet/mrls/081502en.pdf; NB. Colistin base has an assigned potency of 30 000 IU/mg
12. Giamarellos-Bourboulis EJ, Sambatakou H, Galani I, Giamarellou H. (2003). "In vitro interaction of colistin and rifampin on multidrug-resistant Pseudomonas aeruginosa". J Chemother 15 (4): 235–38. doi:10.1159/000069498. PMID 12686786.
13. Hogg GM, Barr JG, Webb CH. (1998). "In-vitro activity of the combination of colistin and rifampicin against multidrug-resistant strains of Acinetobacter baumannii". J Antimicrob Chemother 41 (4): 494–95. doi:10.1093/jac/41.4.494.
14. Petrosillo N, Chinello P, Proietti MF, et al. (2005). "Combined colistin and rifampicin therapy for carbapenem-resistant Acinetobacter baumannii infections: clinical outcome and adverse events". Clin Microbiol Infect 11 (8): 682–83. doi:10.1111/j.1469-0691.2005.01198.x. PMID 16008625.
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Product Notes
The Colistin Sulfate (Catalog #AAA6048071) is a Biochemical produced from Source: Synthetic and is intended for research purposes only. The product is available for immediate purchase. It is sometimes possible for the material contained within the vial of "Colistin Sulfate, Biochemical" to become dispersed throughout the inside of the vial, particularly around the seal of said vial, during shipment and storage. We always suggest centrifuging these vials to consolidate all of the liquid away from the lid and to the bottom of the vial prior to opening. Please be advised that certain products may require dry ice for shipping and that, if this is the case, an additional dry ice fee may also be required.Precautions
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