The DOI matches its Crossref record; 733 of the 733 references it cites were found in a registry or an index.
Efflux-mediated antimicrobial resistance
Abstract
Antibiotic resistance continues to plague antimicrobial chemotherapy of infectious disease. And while true biocide resistance is as yet unrealized, in vitro and in vivo episodes of reduced biocide susceptibility are common and the history of antibiotic resistance should not be ignored in the development and use of biocidal agents. Efflux mechanisms of resistance, both drug specific and multidrug, are important determinants of intrinsic and/or acquired resistance to these antimicrobials, with some accommodating both antibiotics and biocides. This latter raises the spectre (as yet generally unrealized) of biocide selection of multiple antibiotic-resistant organisms. Multidrug efflux mechanisms are broadly conserved in bacteria, are almost invariably chromosome-encoded and their expression in many instances results from mutations in regulatory genes. In contrast, drug-specific efflux mechanisms are generally encoded by plasmids and/or other mobile genetic elements (transposons, integrons) that carry additional resistance genes, and so their ready acquisition is compounded by their association with multidrug resistance. While there is some support for the latter efflux systems arising from efflux determinants of self-protection in antibiotic-producing Streptomyces spp. and, thus, intended as drug exporters, increasingly, chromosomal multidrug efflux determinants, at least in Gram-negative bacteria, appear not to be intended as drug exporters but as exporters with, perhaps, a variety of other roles in bacterial cells. Still, given the clinical significance of multidrug (and drug-specific) exporters, efflux must be considered in formulating strategies/approaches to treating drug-resistant infections, both in the development of new agents, for example, less impacted by efflux and in targeting efflux directly with efflux inhibitors.
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In the citing paper
“The presence of multidrug efflux-related genes such as mexX, mexY and patB further supports the hypothesis that fluoride exposure may indirectly shape oral resistance by modulating bacterial stress response [58].”
From Severity-dependent alterations in oral microbiota and antibiotic resistance in children with dental fluorosis (2026) · cites this paper as [58]
In the citing paper
“Importantly, many of these pumps affect tetracycline and doxycycline, but do not decrease minocycline or tigecycline susceptibility, as they are not able to use these compounds as substrates (44, 47).”
From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [44]
In the citing paper
“Finally, another predicted efflux pump is Lsa (encoded by the chromosomal gene lsa), which is responsible for the intrinsic resistance of E. faecalis to lincosamides and streptogramin A (LSA phenotype) (44, 45).”
From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [44]
In the citing paper
“These systems may be substrate-specific (for a particular antibiotic such as tet determinants for tetracycline and mef genes for macrolides in pneumococci) or with broad substrate specificity, which are usually found in MDR bacteria (44).”
From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [44]
Citations
Cites
1 retracted
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Efflux-mediated heavy metal resistance in prokaryotes
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Multidrug-resistance efflux pumps ? not just for resistance
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Flagged first, then by citations
Research works printed but not linked: 2
- Bartlett JG. 2004 Pocket Book of Infectious Disease Therapy, 12 edn. Baltimore: Lippincott Williams & Wilkins, 2004.
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Cited by
Sorted by citations
Origins and evolution of antibiotic resistance
Davies, J., & Davies, D. (2010) · Microbiology and Molecular Biology Reviews · doi:10.1128/mmbr.00016-10 · Cited by 5,784
Mechanisms of Antibiotic Resistance
Munita, J. M., & Arias, C. A. (2016) · Microbiology Spectrum · doi:10.1128/microbiolspec.vmbf-0016-2015 · Cited by 2,782
Antimicrobial Resistance: A Growing Serious Threat for Global Public Health
Salam, M. A., Al-Amin, M. Y., Salam, M. T., Pawar, J. S., Akhter, N., Rabaan, A. A., & Alqumber, M. A. A. (2023) · Healthcare · doi:10.3390/healthcare11131946 · Cited by 2,622
Call of the wild: antibiotic resistance genes in natural environments
Allen, H. K., Donato, J., Wang, H. H., Cloud-Hansen, K. A., Davies, J., & Handelsman, J. (2010) · Nature Reviews Microbiology · doi:10.1038/nrmicro2312 · Cited by 2,361
Multidrug Resistance in Bacteria
Nikaido, H. (2009) · Annual Review of Biochemistry · doi:10.1146/annurev.biochem.78.082907.145923 · Cited by 1,776
Metadata
- Authors
- Poole, K.
- Affiliations
- Queen's University (CA)
- Corresponding author
- Poole, Keith
- ORCID
- Poole, Keith
- Venue
- Journal of Antimicrobial Chemotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-05-24
- Volume
- 56
- Issue
- 1
- Pages
- 20-51
- ISSN
- 0305-7453 (ISSN-L)
- 1460-2091
- OpenAlex
- W2131256712
- Cited by
- 1,082
- References
- 733
- Citations by year
- 2026: 37 · 2025: 50 · 2024: 54 · 2023: 54 · 2022: 43 · 2021: 63 · 2020: 57 · 2019: 52 · 2018: 48 · 2017: 52 · 2016: 70 · 2015: 52 · 2014: 61 · 2013: 57 · 2012: 54
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Antimicrobial Chemotherapy (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Bacterial Genetics and Biotechnology
- Keywords
- efflux-mediated resistance, antimicrobial resistance, multidrug efflux pumps, biocide resistance, multidrug resistance, plasmid-encoded resistance genes, integrons, transposable elements, mobile genetic elements, efflux pump inhibitors, Gram-negative bacteria, intrinsic resistance, acquired resistance
- MeSH terms
- Aminoglycosides, Anti-Bacterial Agents, Biological Transport, Chloramphenicol, Tetracycline, Fluoroquinolones, Drug Resistance, Bacterial, Drug Resistance, Multiple, Bacterial
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