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<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
      <Volume-Issue>Volume 11, Issue 2</Volume-Issue>
      <Season>October - December 2020</Season>
          <FirstName>Dr. A.</FirstName>
          <FirstName>Dr. C.</FirstName>
          <FirstName>Dr. R. Indra</FirstName>
          <FirstName>Dr. S.</FirstName>
      <Abstract>Introduction: Colistin belongs to the family of Polymyxins, cationic polypeptides, with broad-spectrum activity against Gram-negative bacteria. In spite of their toxicity, Polymyxins have important therapeutic options in many hospitals. Carbapenem-resistance occurs in Enterobacteriaceae due to the enzyme carbapenemase produced by them. Most of the Carbapenem resistant gram negative bacteria are found to be resistant to Colistin as well. The colistin resistance in Gram-negative bacteria is because of modifications of lipid A by addition of 4-amino-4-deoxy-L-arabinose (L-Ara4N) and/or phosphoethanolamine (PEtn) to reduce the net LPS negative charge (affinity). Aim __ampersandsign Objectives: To isolate carbapenem resistant Gram Negative Bacilli (GNB) from blood samples collected from septicemic patients and to detect Colistin resistance among them. Materials and Methods: This cross sectional prospective study was conducted for a period of 2 years from July 2015 to May 2017.1108 blood samples were collected from hospitalized patients with septicaemia and Carbapenem resistance was detected by disk diffusion method. The isolates that showed the zone size of less than 19mm to Imipenem were considered to be resistant and were tested for Colistin resistance. Colistin resistance was determined by MIC as per Standard Guidelines. Result: Out of 1108 blood samples, 106 gram negative bacilli were isolated. In that, 22 isolates were Carbapenem resistant and 4 isolates were Colistin resistant of which 1 (25%) was Klebsiella species, 2 [50%] Pseudomonas species and 1 [25%] Acinetobacter species.</Abstract>
      <Keywords>Colistin resistance, Septicaemia, Carbapenemase, Gram negative bacilli, Modified Hodge Test, Microbroth dilution method</Keywords>
        <Abstract>https://njbms.in/ubijournal-v1copy/journals/abstract.php?article_id=13255&amp;title=DETECTION OF COLISTIN RESISTANCE AMONG CARBAPENEM RESISTANT GRAM NEGATIVE BACILLI IN SEPTICAEMIC PATIENTS AT A TERITARY CARE HOSPITAL</Abstract>
1. Chew KL, La MV, Lin RTP, Teo JWP. Colistin and Polymyxin B susceptibility testing for Carbapenem-resistant and mcr-positive Enterobactericeae: Comparison of Sensititre, Microscan, Vitek 2 and E test with Broth microdilution. 2017;55:2609-2616. 2. David Landman , Claudiu Georgescu, Don Antonio Martin, John Quale. Polymyxins revisited. 2008 Jul; 21(3):449-65.&#13;
3. Y Koyama, A Kurosasa, A Tsuchiya, K Takakuta. "A new antibiotic and;#39;colistinand;#39; produced by spore-forming soil bacteria". J Antibiot (Tokyo).1950;(3) 457-458.&#13;
4. Falagas M, Kasiakou S. "Colistin: The Revival of Polymyxins for the Management of Multidrug-Resistant Gram-Negative Bacterial Infections". Rev Anti Infect Agen. May 2005;40(9):1333-41.&#13;
5. Moore RA, Bates NC, Hancock RE. 1986. Interaction of polycationic antibiotics with Pseudomonas aeruginosa lipopolysaccharide and lipid A studied by using dansyl-polymyxin. Antimicrob Agents Chemother 29: 496–500.&#13;
6. Motaouakkil S, Charra B, Hachimi A, Nejmi H, Benslama A, Elmdaghri N, Belabbes H, Benbachir M. "Colistin and rifampicin in the treatment of nosocomial infections from multiresistant Acinetobacter baumannii". Journal of Infection. 2006;53 (4): 274–278. 7. Abiola O. Olaitan, Serge Morand, and Jean-Marc Rolain. Mechanisms of polymyxin resistance: acquired and intrinsic resistance in bacteria. 2014; 5:643.&#13;
8. Betty A.Forbes, Daniel F.Sahm, Alice S. Weissfeld. Bailey and; Scott’s Diagnostic Microbiology -12th edition. 2007:784-786. 9. Clinical and Laboratory Standards Institute (CLSI) Performance standards for antimicrobial susceptibility testing; 23rd Informational supplement M100-S23. Wayne: CLSI; 2013.&#13;
10. EUCAST. Recommendations for MIC determination of Colistin (Polymyxin E) as recommended by the Joint CLSI-EUCAST Polymyxin breakpoints working group. 2016.&#13;
11. Lee, Mary. Basic Skills in Interpreting Laboratory Data (5 ed.). ASHP. ISBN 9781585283453. Retrieved 16 November 2014;723.&#13;
12. IrithWeigand, kai Hilpert, Robert E W Hancock. Agar and Broth dilution methods to determine the Minimum&#13;
inhibitory concentration (MIC) of antimicrobial substances.2008;3(2):163-75.&#13;
13. Silvana Oliveira dos Santos, Sthefanine Martins La Rocca, Rosmari Horner. Colistin resistance in non-fermenting Gram-negative bacilli in a university hospital. 2016;20 (6):1678-4391.&#13;
14. Mai M. Zafer, Hadir A. El-Mahallawy, Asmaa Abdulhak, Magdy A. Amin, Mohamed H. Al-Agamy and; Hesham H. Radwan. Emergence of colistin resistance in multidrug-resistant Klebsiella pneumoniae and Escherichia coli strains isolated from cancer patients.2019;40&#13;
15. Olaitan AO, Diene SM, Kempf M, Berrazeg M, Bakour S, Gupta SK, et al. Worldwide emergence of colistin resistance in Klebsiella pneumoniae from healthy humans and patients in Lao PDR, Thailand, Israel, Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB: an epidemiological and molecular study. Int J Antimicrob Agents. 2014;44:500–7.&#13;
16. Munford R. S., Murphy T. V. Antimicrobial resistance in Streptococcus pneumoniae: can immunization prevent its spread? J. Invest. Med.1994;42:613-621.&#13;
17. Sham D. F., O’Brien T. F. Detection and surveillance of antimicrobial resistance.Trends Microbiol.1994;2(10):366-371.&#13;
18. Sham D. F. The role of clinical microbiology in the control and surveillance of antimicrobial resistance.ASM News.1996.</References>