ArticleAntibiotics (Basel, Switzerland)2020
The Role of Efflux Pumps in the Transition from Low-Level to Clinical Antibiotic Resistance.
Article in Antibiotics (Basel, Switzerland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed, 61 citations in OpenAlex.
- Efflux-mediated carbapenem resistance: unveiling genetic drivers, clinical implications, and strategies for global antimicrobial stewardship.Antonie van Leeuwenhoek · 2026Review
- Article
- Antimicrobial Armageddon: The Professional Guide to Conquering Antibiotic Resistance.Probiotics and antimicrobial proteins · 2026Article
- Medicinal Plants: A Promising Therapeutic Approach for Addressing Antimicrobial Resistance.International journal of molecular sciences · 2026Review
- Berberine Interferes with the Molecular Landscape of Biofilm-Driven Pathogenicity.Pathogens (Basel, Switzerland) · 2026Review
- Molecular basis of ampicillin resistance: combinatorial mechanisms and future strategies.World journal of microbiology & biotechnology · 2026Review
- Genes and physiological strategies in bacterial antibiotic resistance.Frontiers in microbiology · 2026Review
- Effect of sub-inhibitory tigecycline (½-MIC) on AcrAB-TolC andFrontiers in cellular and infection microbiology · 2026Article
- Fecal carriage, transferable β-lactam resistance, and efflux pump contribution in third-generation cephalosporin-resistantVeterinary world · 2026Article
- Conformational plasticity across phylogenetic clusters of RND multidrug efflux pumps and its impact on substrate specificity.Nature communications · 2025Article
- Bacterial Proteomics and Antibiotic Resistance Identification: Is Single-Cell Analysis a Worthwhile Pursuit?Pathogens (Basel, Switzerland) · 2025Review
- An Overview of the Epidemiology of Multidrug Resistance and Bacterial Resistance Mechanisms: What Solutions Are Available? A Comprehensive Review.Microorganisms · 2025Review
- Efflux-Mediated Resistance inAntibiotics (Basel, Switzerland) · 2025Review
- Bacterial strain type and TEM-1 enzyme allele impact antibiotic susceptibility distribution in monoclonal populations: a single-cell droplet approach.Royal Society open science · 2025Article
- Acquired Bacterial Resistance to Antibiotics and Resistance Genes: From Past to Future.Antibiotics (Basel, Switzerland) · 2025Review
- Targeting Acinetobacter baumannii resistance-nodulation-division efflux pump transcriptional regulators to combat antimicrobial resistance.npj antimicrobials and resistance · 2025Review
- Fluoroquinolone resistance in ESKAPE pathogens: evolutionary pathways, one health transmission, and clinical surveillance.Frontiers in microbiology · 2025Review
- Identification and characterisation of two functional antibiotic MATE efflux pumps in the archaeon Halorubrum amylolyticum.npj antimicrobials and resistance · 2024Article
- Types and Mechanisms of Efflux Pump Systems and the Potential of Efflux Pump Inhibitors in the Restoration of Antimicrobial Susceptibility, with a Special Reference toPathogens (Basel, Switzerland) · 2024Review
- Efflux-mediated Multidrug Resistance in Critical Gram-negative Bacteria and Natural Efflux Pump Inhibitors.Current drug research reviews · 2024Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.