• A systematic review and meta-analysis published in the Journal of Antimicrobial Chemotherapy found the prevalence of polymyxin-resistant bacterial strains in India.

• Polymyxins, a last-resort antibiotic class for multidrug-resistant gram-negative bacteria, have seen increased resistance due to their extensive use.

• The meta-analysis of 41 studies with 24,589 gram-negative bacterial isolates found a 15% resistance rate in India, compared to the global average of 10%.

• Tamil Nadu reported the highest resistance at 28.3%, followed by Uttar Pradesh (16.3%) and Odisha (15.9%). 

• Clinical sources accounted for 89% of resistant isolates, while environmental sources accounted for 11%. 

• The use of polymyxins in the healthcare sector and poultry farms as growth promoters contributes to the rising incidence of polymyxin resistance.

• Among the resistant isolates, 8.4% contained plasmid-borne mcr genes, which confer resistance to colistin and can spread between bacterial species.

• The study emphasizes the need for periodic surveillance and sustained measures to contain the spread of resistance and to develop improved polymyxins.

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