[Source: Eurosurveillance, full page: (LINK). Summary, edited.]
Eurosurveillance, Volume 22, Issue 31, 03 August 2017 / Editorial
Plasmid-encoded colistin resistance: mcr-one, two, three and counting
J Kluytmans 1
Author affiliations: 1. Amphia Hospital Breda and University Medical Centre Utrecht
Correspondence: Jan Kluytmans (firstname.lastname@example.org)
Citation style for this article: Kluytmans J. Plasmid-encoded colistin resistance: mcr-one, two, three and counting. Euro Surveill. 2017;22(31):pii=30588. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.31.30588
Received:20 July 2017; Accepted:20 July 2017
In November 2015, the first description of plasmid-mediated colistin resistance (mcr-1 gene) was reported from China in food animals, food and humans . Many reports from all over the world have followed since. The reported rates vary considerably, ranging from sporadic findings up to 67% in Escherichia coli isolates from Tunisian chicken . However, the rates have been consistently higher in livestock than in humans. This points to a reservoir in animals with spill over to humans. Until recently, colistin use in humans has been limited but it has been used extensively in veterinary medicine for decades, both as curative treatment and for prevention of disease . The amount of use in livestock varies enormously. In Europe, for example, in 2013, the annual colistin sales in some countries exceeded 20 mg per population corrected unit (PCU) while in other countries the sales were below 1 mg/PCU. Following the detection of mcr-1, the European Medicines Agency updated their advice on the use of colistin in humans and animals  with the aim of reducing the use in animals by 65% in the coming years. Quantitative targets of 5 mg/PCU and 1 mg/PCU have been set for a reduction in high and medium consuming countries, respectively.
Keywords: Antibiotics; Drugs Resistance; Colistin; MCR1; MCR3.