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The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance

Center for Peptide-Based Antibiotics, Department of Biology, University of Copenhagen, 2200 Copenhagen, Denmark
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Received: 30 October 2020 / Revised: 26 November 2020 / Accepted: 26 November 2020 / Published: 30 November 2020
(This article belongs to the Special Issue The Role of Efflux Pump Inhibitor in Bacterial Multidrug 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 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. View Full-Text
Keywords: low-level antibiotic resistance; clinical resistance; efflux pump; efflux pump inhibitors low-level antibiotic resistance; clinical resistance; efflux pump; efflux pump inhibitors
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MDPI and ACS Style

Ebbensgaard, A.E.; Løbner-Olesen, A.; Frimodt-Møller, J. The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance. Antibiotics 2020, 9, 855. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9120855

AMA Style

Ebbensgaard AE, Løbner-Olesen A, Frimodt-Møller J. The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance. Antibiotics. 2020; 9(12):855. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9120855

Chicago/Turabian Style

Ebbensgaard, Anna E., Anders Løbner-Olesen, and Jakob Frimodt-Møller. 2020. "The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance" Antibiotics 9, no. 12: 855. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9120855

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