Journal
FUTURE MICROBIOLOGY
Volume 9, Issue 10, Pages 1165-1177Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/FMB.14.66
Keywords
AcrAB; efflux inhibitor; MarA; MexAB; RamA; regulation; TolC; two component regulatory system
Categories
Funding
- Medical Research Council [G9818340, G0801977, G0901366] Funding Source: researchfish
- MRC [G9818340, G0801977, G0901366] Funding Source: UKRI
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Gram-negative bacteria express a plethora of efflux pumps that are capable of transporting structurally varied molecules, including antibiotics, out of the bacterial cell. This efflux lowers the intracellular antibiotic concentration, allowing bacteria to survive at higher antibiotic concentrations. Overexpression of some efflux pumps can cause clinically relevant levels of antibiotic resistance in Gram-negative pathogens. This review discusses the role of efflux in resistance of clinical isolates of Gram-negative bacteria, the regulatory mechanisms that control efflux pump expression, the recent advances in our understanding of efflux pump structure and how inhibition of efflux is a promising future strategy for tackling multidrug resistance in Gram-negative pathogens.
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