The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance
Antibiotic resistance is on the rise and has become one of the biggest public health challenges of our time. Bacteria are able to adapt to the selective pressure exerted by antibiotics in numerous ways, including the (over)expression of efflux pumps, which represents an ancient bacterial defense mec...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-11-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/9/12/855 |
| _version_ | 1797546202456129536 |
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| author | Anna Elisabeth Ebbensgaard Anders Løbner-Olesen Jakob Frimodt-Møller |
| author_facet | Anna Elisabeth Ebbensgaard Anders Løbner-Olesen Jakob Frimodt-Møller |
| author_sort | Anna Elisabeth Ebbensgaard |
| collection | DOAJ |
| description | Antibiotic resistance is on the rise and has become one of the biggest public health challenges of our time. Bacteria are able to adapt to the selective pressure exerted by antibiotics in numerous ways, including the (over)expression of efflux pumps, which represents an ancient bacterial defense mechanism. Several studies show that overexpression of efflux pumps rarely provides clinical resistance but contributes to a low-level resistance, which allows the bacteria to persist at the infection site. Furthermore, recent studies show that efflux pumps, apart from pumping out toxic substances, are also linked to persister formation and increased spontaneous mutation rates, both of which could aid persistence at the infection site. Surviving at the infection site provides the low-level-resistant population an opportunity to evolve by acquiring secondary mutations in antibiotic target genes, resulting in clinical resistance to the treating antibiotic. Thus, this emphasizes the importance and challenge for clinicians to be able to monitor overexpression of efflux pumps before low-level resistance develops to clinical resistance. One possible treatment option could be an efflux pump-targeted approach using efflux pump inhibitors. |
| first_indexed | 2024-03-10T14:26:44Z |
| format | Article |
| id | doaj.art-f5b246ad34a148fb85c03fce0327ba4a |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T14:26:44Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-f5b246ad34a148fb85c03fce0327ba4a2023-11-20T22:58:15ZengMDPI AGAntibiotics2079-63822020-11-0191285510.3390/antibiotics9120855The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic ResistanceAnna Elisabeth Ebbensgaard0Anders Løbner-Olesen1Jakob Frimodt-Møller2Center for Peptide-Based Antibiotics, Department of Biology, University of Copenhagen, 2200 Copenhagen, DenmarkCenter for Peptide-Based Antibiotics, Department of Biology, University of Copenhagen, 2200 Copenhagen, DenmarkCenter for Peptide-Based Antibiotics, Department of Biology, University of Copenhagen, 2200 Copenhagen, DenmarkAntibiotic resistance is on the rise and has become one of the biggest public health challenges of our time. Bacteria are able to adapt to the selective pressure exerted by antibiotics in numerous ways, including the (over)expression of efflux pumps, which represents an ancient bacterial defense mechanism. Several studies show that overexpression of efflux pumps rarely provides clinical resistance but contributes to a low-level resistance, which allows the bacteria to persist at the infection site. Furthermore, recent studies show that efflux pumps, apart from pumping out toxic substances, are also linked to persister formation and increased spontaneous mutation rates, both of which could aid persistence at the infection site. Surviving at the infection site provides the low-level-resistant population an opportunity to evolve by acquiring secondary mutations in antibiotic target genes, resulting in clinical resistance to the treating antibiotic. Thus, this emphasizes the importance and challenge for clinicians to be able to monitor overexpression of efflux pumps before low-level resistance develops to clinical resistance. One possible treatment option could be an efflux pump-targeted approach using efflux pump inhibitors.https://www.mdpi.com/2079-6382/9/12/855low-level antibiotic resistanceclinical resistanceefflux pumpefflux pump inhibitors |
| spellingShingle | Anna Elisabeth Ebbensgaard Anders Løbner-Olesen Jakob Frimodt-Møller The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance Antibiotics low-level antibiotic resistance clinical resistance efflux pump efflux pump inhibitors |
| title | The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance |
| title_full | The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance |
| title_fullStr | The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance |
| title_full_unstemmed | The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance |
| title_short | The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance |
| title_sort | role of efflux pumps in the transition from low level to clinical antibiotic resistance |
| topic | low-level antibiotic resistance clinical resistance efflux pump efflux pump inhibitors |
| url | https://www.mdpi.com/2079-6382/9/12/855 |
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