The Public Health Risks of Colistin Resistance in Dogs and Cats: A One Health Perspective Review

Colistin, a polymyxin antibiotic considered a last-line treatment for multidrug-resistant Gram-negative infections, has been widely used in livestock, promoting resistance in bacterial populations that can disseminate through the environment. Although rarely used in companion animals, dogs and cats can acquire and spread colistin-resistant strains through shared environments, acting as potential reservoirs of resistance. Reliable detection of resistant strains remains challenging due to technical limitations of routine susceptibility tests. Despite these constraints, epidemiological studies demonstrate the global presence of colistin-resistant bacteria in companion animals, with multiple plasmid-mediated colistin-resistant genes (<i>mcr</i>) identified in different bacteria species. Evidence of clonal and plasmid-mediated sharing of resistant strains between companion animals, humans, and, in some cases, food-producing animals highlights the complex and multidirectional nature of transmission. Although the directionality of transmission remains difficult to establish, the detection of colistin-resistant bacteria in companion animals is concerning. Addressing this challenge requires a One Health approach, integrating coordinated surveillance and infection and control measures in veterinary practices to safeguard the effectiveness of this critical last-resort antibiotic. This review summarizes current knowledge on colistin resistance mechanisms, diagnostic challenges, epidemiology, and the potential for interhost transmission, highlighting the role of dogs and cats as potential reservoirs of colistin resistance.