Detection of mobile colistin-resistance gene variants ( and ) in urinary tract pathogens in Bangladesh: the last resort of infectious disease management colistin efficacy is under threat.

: Currently, colistin-resistant pathogens emerged has become a global health concern. This study assessed the distribution of to variants with the phenotypic colistin-resistance in bacterial isolates from urinary tract infection (UTI) patients in Bangladesh.: A cross-sectional study was conducted between April 2017 and March 2018 to enroll uncomplicated UTI patients, and 142 urine samples were analyzed. Uropathogens were identified using the API-20E biochemical panel and 16s rRNA gene sequencing. Polymerase chain reactions detected the gene variants in the UTI isolates. The phenotypic colistin-susceptibility was determined by the Kirby-Bauer disc-diffusion method and the minimal inhibitory concentration (MIC) measurement.: The combined carriage of and genes in 11.4% (14/123) of urinary tract pathogens. The -positive pathogens include five , three , three , two , and one . The positive variant showed significantly higher phenotypic colistin resistance with MIC between >16 µg/mL and >128 µg/mL (< 0.001). Over 85% of colistin-resistant isolates showed MDR phenomena.: The emergence of the clinical MDR pathogens with resistance to a highly selective drug may lead to a lack of treatment options for the infectious diseases and spread of infection to the unaffected cohorts.