On the edge of the precipice: the rise and proliferation of resistance to colistin, a last resort antibiotic by Issmat Kassem

Issmat Kassem, Assistant Professor, Food Microbiology, FAFS, delivered the lecture: On the edge of the precipice: the rise and proliferation of resistance to colistin, a last resort antibiotic (October 3) at FAFS.


Antibiotics remain a major line of defense against infections. However, the rise of antimicrobial resistance (AMR) has threatened modern medicine and agriculture worldwide. AMR can turn otherwise-treatable infections into life-threatening conditi‚Äčons in both humans and animals. Consequently, AMR has been recognized as a major challenge facing humanity in the 21st century. Of notable concern is the recent discovery and global dissemination of mobile genetic elements (mcr) that can confer resistance to colistin, a last resort antibiotic. 


Colistin has been used to treat complicated infections, and resistance is threatening the efficacy of this important drug. The spread of mcr might be most problematic in countries with limited resources and developing antimicrobial stewardship. In Lebanon, mcr was detected in the food production environment, surface and domestic waters (including those of highly vulnerable, displaced and disenfranchised communities), and humans, while colistin is still being used in agricultural practices, mainly in animal farming. Colistin use for medical purposes appears to have significantly increased in the past 7 years, which might indicate an increase in complicated infections in the population and highlights the importance of preserving colistin. Therefore, the prevalence of colistin resistance and the associated MCR are serious problems that require immediate mitigation in Lebanon.