Evidence map›Paper›PMID 36344198›Full record

ReviewAnnals of the New York Academy of Sciences2023

New understanding of multidrug efflux and permeation in antibiotic resistance, persistence, and heteroresistance.

Pedro D Manrique, Cesar A López, S Gnanakaran, Valentin V Rybenkov, Helen I Zgurskaya

Open access · greenAbstract readReview
In one paragraph

Review in Annals of the New York Academy of Sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
2.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 39 citations in OpenAlex.

  1. Review
  2. From Environmental Organism to Nosocomial Threat:Antibiotics (Basel, Switzerland) · 2026
    Review
  3. Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2026
    Review
  4. Article
  5. Review
  6. Efflux-Mediated Resistance inAntibiotics (Basel, Switzerland) · 2025
    Review
  7. Review
  8. Review
  9. Article
  10. Article
  11. Review
  12. Rhodamine 19 Alkyl Esters as Effective Antibacterial Agents.International journal of molecular sciences · 2024
    Article
  13. Article
  14. Antibiotic class with potent in vivo activity targeting lipopolysaccharide synthesis in Gram-negative bacteria.Proceedings of the National Academy of Sciences of the United States of America · 2024
    Article
  15. Article
  16. Article
  17. Article
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Pedro D ManriqueTheoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, New Mexico, USA.
Cesar A LópezTheoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, New Mexico, USA.
S GnanakaranTheoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, New Mexico, USA.
Valentin V RybenkovDepartment of Chemistry and Biochemistry, University of Oklahoma, Norman, Oklahoma, USA.
Helen I ZgurskayaDepartment of Chemistry and Biochemistry, University of Oklahoma, Norman, Oklahoma, USA.ORCID 0000-0001-8929-4727
Los Alamos National Laboratory · USUniversity of Oklahoma · US

Funding

Transport across two membranes by AcrAB-TolC complexR01AI052293 · NIAID · UNIVERSITY OF OKLAHOMA NORMAN · PI ZGURSKAYA, HELEN I · 2003 to 2024
$7.7M
Optimization of efflux avoidance and inhibition for antibiotic developmentR01AI136799 · NIAID · UNIVERSITY OF OKLAHOMA · PI GNANAKARAN, SANDRASEGARAM, RUGGERONE, PAOLO · 2018 to 2022
$5.7M
Permeability Barriers of Gram-negative Pathogens and Approaches to Bypass ThemR01AI132836 · NIAID · UNIVERSITY OF OKLAHOMA · PI HELEN I ZGURSKAYA · 2017 to 2026
$4.3M
NIAID NIH HHS R01 AI052293NIAID NIH HHS R01 AI132836NIAID NIH HHS R01 AI136799
6 · The paper itself

Abstract

Antibiotics effective against Gram-negative ESKAPE pathogens are a critical area of unmet need. Infections caused by these pathogens are not only difficult to treat but finding new therapies to overcome Gram-negative resistance is also a challenge. There are not enough antibiotics in development that target the most dangerous pathogens and there are not enough novel drugs in the pipeline. The major obstacle in the antibiotic discovery pipeline is the lack of understanding of how to breach antibiotic permeability barriers of Gram-negative pathogens. These barriers are created by active efflux pumps acting across both the inner and the outer membranes. Overproduction of efflux pumps alone or together with either modification of the outer membrane or antibiotic-inactivating enzymes and target mutations contribute to clinical levels of antibiotics resistance. Recent efforts have generated significant advances in the rationalization of compound efflux and permeation across the cell envelopes of Gram-negative pathogens. Combined with earlier studies and novel mathematical models, these efforts have led to a multilevel understanding of how antibiotics permeate these barriers and how multidrug efflux and permeation contribute to the development of antibiotic resistance and heteroresistance. Here, we discuss the new developments in this area.

Indexed as

Cell WallGram-Negative BacteriaAnti-Bacterial AgentsBiological TransportDrug Resistance, MicrobialHumansAnti-Bacterial Agentsdrug permeationGram-negative bacteriamathematical modelsmultidrug efflux

Identifiers

PMID36344198
PMCPMC9839546
OpenAlexW4308388707

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.