Thet KT et al (2020) Jul., Colistin heteroresistance in carbapenem-resistant Acinetobacter baumannii clinical isolates from a Thai university hospital, World J Microbiol Biotechnol, vol. 36, no. 7, p. 102, https://doi.org/10.1007/s11274-020-02873-8

Xu A et al (Dec. 2020) Diagnosis of severe community-acquired pneumonia caused by Acinetobacter baumannii through next-generation sequencing: a case report. BMC Infect Dis 20(1):45. https://doi.org/10.1186/s12879-019-4733-5

Kamali M et al (2020) Prevalence and antibiotic resistance of Acinetobacter baumannii among patients in postcardiac surgery intensive care units of Rajaei Hospital, Tehran. Med J Islam Repub Iran 34(4). https://doi.org/10.34171/mjiri.34.4

Ahsan U et al (2022) Sep., Emergence of high colistin resistance in carbapenem resistant Acinetobacter baumannii in Pakistan and its potential management through immunomodulatory effect of an extract from Saussurea lappa, Front Pharmacol, vol. 13, https://doi.org/10.3389/fphar.2022.986802

ul Ain Q, Naim A, Saeed A (Jul. 2019) Prevalence and Resistance Profile of Clinical isolates of Acinetobacter species from Karachi, Pakistan. RADS J Biol Res Appl Sci 10(1):6–13. https://doi.org/10.37962/jbas.v10i1.163

Talib S, Ahmed A, Abid SH, Assad T, Nizamuddin M, Sharif S (2024) Unveiling colistin resistance in extensively drug-resistant microorganisms among ICU patients of tertiary care hospital Karachi, Pakistan, Pakistan Journal of Pathology, vol. 35, no. 1, pp. 7–12, Mar. https://doi.org/10.55629/pakjpathol.v35i1.800

Kon H et al (Jun. 2023) Prevalence and clinical consequences of Colistin Heteroresistance and Evolution into full resistance in Carbapenem-Resistant Acinetobacter baumannii. Microbiol Spectr 11(3). https://doi.org/10.1128/spectrum.05093-22

Andersson DI, Nicoloff H, Hjort K (Aug. 2019) Mechanisms and clinical relevance of bacterial heteroresistance. Nat Rev Microbiol 17(8):479–496. https://doi.org/10.1038/s41579-019-0218-1

Alousi S et al (Sep. 2024) Genetic and structural basis of colistin resistance in Klebsiella pneumoniae: unravelling the molecular mechanisms. J Glob Antimicrob Resist 38:256–264. https://doi.org/10.1016/j.jgar.2024.06.019

Charretier Y et al (Sep. 2018) Colistin Heteroresistance and involvement of the PmrAB Regulatory System in Acinetobacter baumannii. Antimicrob Agents Chemother 62(9). https://doi.org/10.1128/AAC.00788-18

Band VI et al (2016) May., Antibiotic failure mediated by a resistant subpopulation in Enterobacter cloacae, Nature Microbiology 2016 1:6, vol. 1, no. 6, pp. 1–9, https://doi.org/10.1038/nmicrobiol.2016.53

Band VI, Satola SW, Burd EM, Farley MM, Jacob JT, Weiss DS (2018) Carbapenem-resistant Klebsiella pneumoniae exhibiting clinically undetected colistin heteroresistance leads to treatment failure in a murine model of infection, mBio, vol. 9, no. 2, Mar. https://doi.org/10.1128/MBIO.02448-17/ASSET/1B632FFD-1EF2-4075-A3A7-A9C28323A0D3/ASSETS/GRAPHIC/MBO0021837700002.JPEG

Martínez-Servat S et al (2018) Nov., Heterogeneous colistin-resistance phenotypes coexisting in stenotrophomonas maltophiliaisolates influence colistin susceptibility testing, Front Microbiol, vol. 9, no. NOV, p. 420496, https://doi.org/10.3389/FMICB.2018.02871/BIBTEX

MacDonald L et al (Feb. 2023) Polymyxin Resistance and Heteroresistance are common in clinical isolates of Achromobacter species and correlate with modifications of the lipid a Moiety of Lipopolysaccharide. Microbiol Spectr 11(1). https://doi.org/10.1128/SPECTRUM.03729-22/SUPPL_FILE/SPECTRUM.03729-22-S0001.PDF

Li J et al (2006) Sep., Heteroresistance to Colistin in Multidrug-Resistant Acinetobacter baumannii, Antimicrob Agents Chemother, vol. 50, no. 9, pp. 2946–2950, https://doi.org/10.1128/AAC.00103-06

Sherman EX, Wozniak JE, Weiss DS (2019) Methods to Evaluate Colistin Heteroresistance in Acinetobacter baumannii. 39–50. https://doi.org/10.1007/978-1-4939-9118-1_4

Sánchez-León I, García-Martínez T, Diene SM, Pérez-Nadales E, Martínez-Martínez L, Rolain J-M (Jun. 2023) Heteroresistance to Colistin in Clinical isolates of Klebsiella pneumoniae producing OXA-48. Antibiotics 12(7):1111. https://doi.org/10.3390/antibiotics12071111

Papazachariou A, Tziolos R-N, Karakonstantis S, Ioannou P, Samonis G, Kofteridis DP (May 2024) Treatment strategies of Colistin Resistance Acinetobacter baumannii infections. Antibiotics 13(5):423. https://doi.org/10.3390/antibiotics13050423

Falagas ME, Makris GC, Dimopoulos G, Matthaiou DK (Feb. 2008) Heteroresistance: a concern of increasing clinical significance? Clin Microbiol Infect 14(2):101–104. https://doi.org/10.1111/j.1469-0691.2007.01912.x

CLSI supplement M100. Clinical and Laboratory Standards Institute (2023)

M100 Performance Standards for Antimicrobial Susceptibility Testing A CLSI supplement for global application. 33rd Edition. [Online]. Available: www.clsi.org

ISO (the International Organization for Standardization), Susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility test devices — Part 1: Broth micro-dilution reference method for testing the in vitro activity of antimicrobial agents against rapidly growing aerobic bacteria involved in infectious diseases, vol. ISO 20776-1:2019(en)

Kuang Q et al (Oct. 2020) R 93 P substitution in the PmrB HAMP Domain contributes to Colistin Heteroresistance in Escherichia coli isolates from Swine. Antimicrob Agents Chemother 64(11). https://doi.org/10.1128/AAC.01509-20

Olaitan AO, Morand S, Rolain J-M (Nov. 2014) Mechanisms of polymyxin resistance: acquired and intrinsic resistance in bacteria. Front Microbiol 5. https://doi.org/10.3389/fmicb.2014.00643

Srinivas P et al (Jun. 2018) Detection of colistin heteroresistance in Acinetobacter baumannii from blood and respiratory isolates. Diagn Microbiol Infect Dis 91(2):194–198. https://doi.org/10.1016/j.diagmicrobio.2018.01.028

Hawley JS, Murray CK, Jorgensen JH (Jan. 2008) Colistin heteroresistance in acinetobacter and its association with previous colistin therapy. Antimicrob Agents Chemother 52(1):351–352. https://doi.org/10.1128/AAC.00766-07

D. GAZEL and M. TATMAN OTKUN, Investigation of Colistin Heteroresistance and some factors affecting Heteroresistance in Carbapenem-Resistant A. baumannii strains. Mediterranean J Infect Microbes Antimicrobials, (2018) https://doi.org/10.4274/mjima.2017.1

Barin J, Martins AF, Heineck BL, Barth AL, Zavascki AP (Dec. 2013) Hetero- and adaptive resistance to polymyxin B in OXA-23-producing carbapenem-resistant Acinetobacter baumannii isolates. Ann Clin Microbiol Antimicrob 12(1):15. https://doi.org/10.1186/1476-0711-12-15

Rodriguez CH et al (2010) Feb., In vitro antimicrobials activity against endemic Acinetobacter baumannii multiresistant clones, The Journal of Infection in Developing Countries, vol. 4, no. 03, pp. 164–167, https://doi.org/10.3855/jidc.604

Hernan RC, Karina B, Gabriela G, Marcela N, Carlos V, Angela F (2009) Selection of colistin-resistant Acinetobacter baumannii isolates in postneurosurgical meningitis in an intensive care unit with high presence of heteroresistance to colistin, Diagn Microbiol Infect Dis, vol. 65, no. 2, pp. 188–191, Oct. https://doi.org/10.1016/j.diagmicrobio.2009.05.019

Herrera ME, Mobilia LN, Posse GR (2011) [Comparative evaluation of the sensitivity of Acinetobacter to colistin, using the prediffusion and minimum inhibitory concentration methods: detection of heteroresistant isolates]. Rev Argent Microbiol 43(2):115–119. https://doi.org/10.1590/S0325-75412011000200009

Article  CAS  PubMed  Google Scholar 

Nicoloff H, Hjort K, Levin BR, Andersson DI (Feb. 2019) The high prevalence of antibiotic heteroresistance in pathogenic bacteria is mainly caused by gene amplification. Nat Microbiol 4(3):504–514. https://doi.org/10.1038/s41564-018-0342-0

Chen L et al (2020) Jul., Deciphering colistin heteroresistance in Acinetobacter baumannii clinical isolates from Wenzhou, China, J Antibiot (Tokyo), vol. 73, no. 7, pp. 463–470, https://doi.org/10.1038/s41429-020-0289-2

Yau W et al (Feb. 2009) Colistin hetero-resistance in multidrug-resistant Acinetobacter baumannii clinical isolates from the Western Pacific region in the SENTRY antimicrobial surveillance programme. J Infect 58(2):138–144. https://doi.org/10.1016/j.jinf.2008.11.002

Cai Y, Chai D, Wang R, Liang B, Bai N (2012) Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies, Journal of Antimicrobial Chemotherapy, vol. 67, no. 7, pp. 1607–1615, Jul. https://doi.org/10.1093/jac/dks084

El-Halfawy OM, Valvano MA (Jan. 2015) Antimicrobial Heteroresistance: an emerging field in need of clarity. Clin Microbiol Rev 28(1):191–207. https://doi.org/10.1128/CMR.00058-14

Band VI et al (Feb. 2021) Colistin Heteroresistance is largely undetected among Carbapenem-Resistant enterobacterales in the United States. mBio 12(1). https://doi.org/10.1128/mBio.02881-20

Lo-Ten-Foe JR, de Smet AMGA, Diederen BMW, Kluytmans JAJW, van Keulen PHJ (2007) Comparative Evaluation of the VITEK 2, Disk Diffusion, Etest, Broth Microdilution, and Agar Dilution Susceptibility Testing Methods for Colistin in Clinical Isolates, Including Heteroresistant Enterobacter cloacae and Acinetobacter baumannii Strains, Antimicrob Agents Chemother, vol. 51, no. 10, pp. 3726–3730, Oct. https://doi.org/10.1128/AAC.01406-06

Tiseo G, Galfo V, Falcone M (2023) What is the clinical significance of ‘heteroresistance’ in nonfermenting Gram-negative strains? Curr Opin Infect Dis, vol. 36, no. 6, pp. 555–563, Dec. https://doi.org/10.1097/QCO.0000000000000964

da Silva KE, Rossato L, Leite AF, Simionatto S (2022) Overview of polymyxin resistance in Enterobacteriaceae. Rev Soc Bras Med Trop 55. https://doi.org/10.1590/0037-8682-0349-2021

Al-Tamimi M et al (Apr. 2022) Multidrug-Resistant Acinetobacter baumannii in Jordan. Microorganisms 10(5):849. https://doi.org/10.3390/microorganisms10050849

Sciarra F, Campolo F, Franceschini E, Carlomagno F, Venneri M (Mar. 2023) Gender-specific impact of sex hormones on the Immune System. Int J Mol Sci 24(7):6302. https://doi.org/10.3390/ijms24076302

Hafiz TA et al (2023) Mar., A two-year retrospective study of multidrug-resistant Acinetobacter baumannii respiratory infections in critically Ill patients: Clinical and microbiological findings, J Infect Public Health, vol. 16, no. 3, pp. 313–319, https://doi.org/10.1016/j.jiph.2023.01.004

Zhu Y et al (Nov. 2022) Insight into carbapenem resistance and virulence of Acinetobacter baumannii from a children’s medical centre in eastern China. Ann Clin Microbiol Antimicrob 21(1). https://doi.org/10.1186/s12941-022-00536-0