Delineating molecular mechanisms on the acquisition of <i>in vitro-</i> adapted colistin-resistant <i>Klebsiella pneumoniae</i> by transcriptomic analysis

Nowadays, only a few treatment options remain for widespread multidrug-resistant (MDR) Gram-negative bacterial infections, including the old antibiotic colistin. However, colistin-resistant clinical pathogens are spreading globally, further limiting treatment options. The future does not look promising due to the increasing global use of antibiotics and the uncontrolled spread of MDR pathogens. Moreover, the development of novel antibiotics has been limited in the industrial sector due to the rapid adaptation of the clinical pathogens. Therefore, the hope relies solely on the development of novel strategies and technologies to manage bacterial infections or limit bacterial adaptations. In this study, a new strategy has been proposed based on findings from <i>in vitro</i> colistin pressure to limit bacterial adaptation to colistin. Given the growing future concerns, the novel perspectives proposed in this study could provide a fundamental basis for developing novel materials or measures to limit antimicrobial adaptation in clinical environments.