Global prevalence of mutation in the gene among clinical isolates of colistin-resistant : a systematic review and meta-analysis.

Background: Colistin is used as a last resort for managing infections caused by multidrug-resistant bacteria. However, the high emergence of colistin-resistant strains has restricted the clinical use of this antibiotic in the clinical setting. In the present study, we evaluated the global prevalence of the mutation in the gene, one of the most important mechanisms of colistin resistance in .

Methods: Several databases, including Scopus, Medline (via PubMed), and Web of Science, were searched (until August 2023) to identify those studies that address the mutation in clinical isolates of . Using Stata software, the pooled prevalence of mutation and subgroup analyses for the year of publication, country, continent, mutation types, and detection methods of mutation were analyzed.

Results: Out of the 115 studies included in the analysis, the prevalence of mutations in colistin-resistant isolates was estimated at 65% of isolates, and variations with insertional inactivation had the highest prevalence among the five investigated mutations with 69%. The year subgroup analysis indicated an increase in mutated from 46% in 2014 to 61% in 2022. Europe had the highest prevalence of mutated at 73%, while Africa had the lowest at 54%.

Conclusion: Mutations in the gene are reported as one of the most common mechanisms of colistin resistance in and the results of the present study showed that 65% of the reported colistin-resistant had a mutation in this gene.