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Meanwhile, colistin is used in the veterinary medicine since its discovery, leading to a steadily increasing prevalence of resistant isolates in the livestock and meat-based food sector. Consequently, transmission of resistant isolates from animals to humans, acquisition via food and exposure to colistin in the clinic are reasons for the increased prevalence of colistin-resistant Enterobacterales in humans in the last decades. Initially, resistance mechanisms were caused by mutations in chromosomal genes. However, since the discovery in 2015, the focus has shifted exclusively to mobile colistin resistances (mcr). This review will advance the understanding of chromosomal-mediated resistance mechanisms in Enterobacterales. We provide an overview about genes involved in colistin resistance and the current global situation of colistin-resistant Enterobacterales. A comparison of the global colistin use in veterinary and human medicine highlights the effort to reduce colistin sales in veterinary medicine under the One Health approach. In contrast, it uncovers the alarming rise in colistin consumption in human medicine due to the emergence of MDR Enterobacterales, which might be an important driver for the increasing emergence of chromosome-mediated colistin resistance.<\/jats:p>","DOI":"10.1093\/femsre\/fuab049","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T23:40:51Z","timestamp":1633477251000},"source":"Crossref","is-referenced-by-count":171,"title":["Global colistin use: a review of the emergence of resistant <i>Enterobacterales<\/i> and the impact on their genetic basis"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1963-1916","authenticated-orcid":false,"given":"Ulrike","family":"Binsker","sequence":"first","affiliation":[{"name":"Unit Epidemiology, Zoonoses and Antimicrobial Resistance, Department Biological Safety, German Federal Institute for Risk Assessment, Diedersdorfer Weg 1, 12277 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"K\u00e4sbohrer","sequence":"additional","affiliation":[{"name":"Unit Epidemiology, Zoonoses and Antimicrobial Resistance, Department Biological Safety, German Federal Institute for Risk Assessment, Diedersdorfer Weg 1, 12277 Berlin, Germany"},{"name":"Department for Farm Animals and Veterinary Public Health, Institute of Veterinary Public Health, University of Veterinary Medicine Vienna, Veterin\u00e4rplatz 1, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6930-4358","authenticated-orcid":false,"given":"Jens A","family":"Hammerl","sequence":"additional","affiliation":[{"name":"Unit Epidemiology, Zoonoses and Antimicrobial Resistance, Department Biological Safety, German Federal Institute for Risk Assessment, Diedersdorfer Weg 1, 12277 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"key":"2022021006110067200_bib1","doi-asserted-by":"crossref","first-page":"e0224281","DOI":"10.1371\/journal.pone.0224281","article-title":"Escherichia coli and Salmonella spp. isolated from Australian meat chickens remain susceptible to critically important antimicrobial agents","volume":"14","author":"Abraham","year":"2019","journal-title":"PLoS ONE"},{"key":"2022021006110067200_bib2","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13756-020-0702-4","article-title":"Antibiogram and beta-lactamase genes among cefotaxime resistant E. coli from wastewater treatment plant","volume":"9","author":"Adegoke","year":"2020","journal-title":"Antimicrob Resist Infect Cont"},{"key":"2022021006110067200_bib3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1089\/fpd.2011.1015","article-title":"Tentative colistin epidemiological cut-off value for Salmonella spp","volume":"9","author":"Agerso","year":"2012","journal-title":"Foodborne Pathog Dis"},{"key":"2022021006110067200_bib6","first-page":"e9714","article-title":"Prevalence of Klebsiella pneumoniae antibiotic resistance in Medina, Saudi Arabia, 2014-2018","volume":"12","author":"Al-Zalabani","year":"2020","journal-title":"Cureus"},{"key":"2022021006110067200_bib4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2807\/1560-7917.ES.2015.20.45.30062","article-title":"Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015","volume":"20","author":"Albiger","year":"2015","journal-title":"Eurosurveillance"},{"key":"2022021006110067200_bib5","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jgar.2018.09.001","article-title":"Genomic analysis of the first isolate of KPC-2-producing Klebsiella pneumoniae from Uruguay","volume":"15","author":"Alvarez","year":"2018","journal-title":"J Glob Antimicrob Resist"},{"key":"2022021006110067200_bib7","doi-asserted-by":"crossref","DOI":"10.1017\/9781108864121","volume-title":"Challenges to Tackling Antimicrobial Resistance: Economic and Policy Responses. 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