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ArticleMolecular biology reports2026

Role of MexAB-OprM and MexXY-OprM efflux pumps in carbapenem-resistant Pseudomonas aeruginosa from burn wounds.

Shahin Khalilipanah, Hadi Sedigh Ebrahim-Saraie, Iraj Nikokar, Hamed Naziri, Meysam Hasannejad-Bibalan

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Article in Molecular biology reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Shahin KhalilipanahBurn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Hadi Sedigh Ebrahim-SaraieDepartment of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. seddigh.hadi@gmail.com.
Iraj NikokarDepartment of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Hamed NaziriDepartment of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Meysam Hasannejad-BibalanDepartment of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. hasannejad@gums.ac.ir.

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6 · The paper itself

Abstract

backgroundPseudomonas aeruginosa remains a major cause of burn wound infections and exhibits a remarkable ability to develop resistance to carbapenems, primarily through multidrug efflux systems belonging to the Resistance-Nodulation-Division (RND) family. This study investigated the contribution of the MexAB-OprM and MexXY-OprM efflux pumps to carbapenem resistance in P. aeruginosa isolates from burn wounds and evaluated the effect of an efflux pump inhibitor on antibiotic susceptibility.

methodsA total of 100 P. aeruginosa isolates were collected from burn patients. Antimicrobial susceptibility to imipenem and meropenem was determined by minimum inhibitory concentration (MIC) assays according to CLSI guidelines. The presence of mexAB-oprM and mexXY-oprM genes was confirmed via PCR. The functional role of efflux activity was assessed using carbonyl cyanide 3-chlorophenylhydrazone (CCCP), a proton-motive force inhibitor, and MIC reductions ≥ 4-fold were interpreted as efflux-mediated resistance.

resultsResistance to imipenem and meropenem was observed in 44% and 27% of isolates, respectively. Among imipenem-resistant isolates, mexXY-oprM was detected in 50% and mexAB-oprM in 18%, while 23% co-presented both systems. In contrast, mexAB-oprM predominated in meropenem-resistant strains (48%), followed by mexXY-oprM (22%). Upon CCCP addition, MICs decreased by ≥ 4-fold in 84% of imipenem-resistant and 52% of meropenem-resistant isolates, suggesting the involvement of efflux pumps (P < 0.05).

conclusionA high prevalence of carbapenem resistance and efflux pump-associated genes was observed among P. aeruginosa isolates from burn wound infections. Significant reductions in carbapenem MICs following CCCP exposure suggest that efflux-mediated mechanisms may contribute to the resistance phenotype in a substantial proportion of isolates. These findings indicate a potential role for efflux activity in carbapenem resistance and warrant further investigation of its clinical and mechanistic significance.

Indexed as

Bacterial Outer Membrane ProteinsBurnsMembrane Transport ProteinsPseudomonas aeruginosaAnti-Bacterial AgentsBacterial ProteinsCarbapenemsDrug Resistance, Multiple, BacterialHumansImipenemMeropenemMicrobial Sensitivity TestsPseudomonas InfectionsAnti-Bacterial AgentsBacterial Outer Membrane ProteinsBacterial ProteinsCarbapenemsImipenemMembrane Transport ProteinsMeropenemMexA protein, Pseudomonas aeruginosaMexB protein, Pseudomonas aeruginosaMexXY protein, Pseudomonas aeruginosaOprM protein, Pseudomonas aeruginosaBurn wound infectionsCarbapenem resistanceEfflux pumpsMexAB-OprMMexXY-OprMPseudomonas aeruginosa

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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.