{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:18:03Z","timestamp":1791371883005,"version":"4.3.1"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["8000 701-3 [HZI]"],"award-info":[{"award-number":["8000 701-3 [HZI]"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["TI06.001"],"award-info":[{"award-number":["TI06.001"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["8032808811"],"award-info":[{"award-number":["8032808811"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The plasmid-located colistin resistance gene\n            <jats:italic>mcr-1<\/jats:italic>\n            confers low-level resistance to colistin, a last-line antibiotic against multidrug-resistant Gram-negative bacteria. Current CLSI-EUCAST recommendations require the use of a broth microdilution (BMD) method with cation-adjusted Mueller-Hinton (CA-MH) medium for colistin susceptibility testing, but approximately 15% of all MCR-1 producers are classified as sensitive in that broth. Here we report on an improved calcium-enhanced Mueller-Hinton (CE-MH) medium that permits simple and reliable determination of\n            <jats:italic>mcr-1<\/jats:italic>\n            -containing\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            . Colistin susceptibility testing was performed for 50\n            <jats:italic>mcr-1<\/jats:italic>\n            -containing\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            and\n            <jats:named-content content-type=\"genus-species\">Klebsiella pneumoniae<\/jats:named-content>\n            isolates, 7 intrinsically polymyxin-resistant species,\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            and\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            isolates with acquired resistance to polymyxins due to\n            <jats:italic>mgrB<\/jats:italic>\n            and\n            <jats:italic>pmrB<\/jats:italic>\n            mutations, respectively, and 32\n            <jats:italic>mcr-1<\/jats:italic>\n            -negative, colistin-susceptible isolates of\n            <jats:named-content content-type=\"genus-species\">Acinetobacter baumannii<\/jats:named-content>\n            ,\n            <jats:named-content content-type=\"genus-species\">Citrobacter freundii<\/jats:named-content>\n            ,\n            <jats:named-content content-type=\"genus-species\">Enterobacter cloacae<\/jats:named-content>\n            ,\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            ,\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            , and\n            <jats:named-content content-type=\"genus-species\">Salmonella enterica<\/jats:named-content>\n            serovar Typhimurium. A comparison of the colistin MICs determined in CA-MH medium and those obtained in CE-MH medium was performed using both the BMD and strip-based susceptibility test formats. We validated the data using an isogenic IncX4 plasmid lacking\n            <jats:italic>mcr-1<\/jats:italic>\n            . Use of the CE-MH broth provides clear separation between resistant and susceptible isolates in both BMD and gradient diffusion assays; this is true for both\n            <jats:italic>mcr-1<\/jats:italic>\n            -containing\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            isolates and those exhibiting either intrinsic or acquired colistin resistance. CE-MH medium is simple to prepare and overcomes current problems associated with BMD and strip-based colistin susceptibility testing, and use of the medium is easy to implement in routine diagnostic laboratories, even in resource-poor settings.\n          <\/jats:p>","DOI":"10.1128\/jcm.01950-17","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T15:52:51Z","timestamp":1520437971000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":21,"title":["An Improved Medium for Colistin Susceptibility Testing"],"prefix":"10.1128","volume":"56","author":[{"given":"Konrad","family":"Gwozdzinski","sequence":"first","affiliation":[{"name":"Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany"},{"name":"German Center for Infection Research, Partner Site Giessen-Marburg-Langen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saina","family":"Azarderakhsh","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany"},{"name":"German Center for Infection Research, Partner Site Giessen-Marburg-Langen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Imirzalioglu","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany"},{"name":"German Center for Infection Research, Partner Site Giessen-Marburg-Langen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Falgenhauer","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany"},{"name":"German Center for Infection Research, Partner Site Giessen-Marburg-Langen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinad","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany"},{"name":"German Center for Infection Research, Partner Site Giessen-Marburg-Langen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1155\/2006\/901873"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/429323"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.4.2.138"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03734.x"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2004.10.001"},{"key":"e_1_3_3_7_2","first-page":"157","article-title":"Colistin: an antibiotic and its role in multiresistant Gram-negative infections","volume":"47","author":"Loho T","year":"2015","unstructured":"Loho T, Dharmayanti A. 2015. 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European Medicines Agency, London, UK. http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Report\/2013\/07\/WC500146813.pdf."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw274"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12342"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2014.914172"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-micro-092412-155751"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05391-11"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2014.00643"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00424-7"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00268-17"},{"key":"e_1_3_3_17_2","unstructured":"European Committee on Antimicrobial Susceptibility Testing. 2016. 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