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Infections arising from multidrug-resistant pathogenic bacteria are spreading rapidly throughout the world and threaten to become untreatable. The origins of resistance are numerous and complex, but one underlying factor is the capacity of bacteria to rapidly export drugs through the intrinsic activity of efflux pumps. In this Review, we describe recent advances that have increased our understanding of the structures and molecular mechanisms of multidrug efflux pumps in bacteria. Clinical and laboratory data indicate that efflux pumps function not only in the drug extrusion process but also in virulence and the adaptive responses that contribute to antimicrobial resistance during infection. The emerging picture of the structure, function and regulation of efflux pumps suggests opportunities for countering their activities.

Original publication

DOI

10.1038/s41579-018-0048-6

Type

Journal article

Journal

Nature reviews. Microbiology

Publication Date

09/2018

Volume

16

Pages

523 - 539

Addresses

Department of Biochemistry, University of Cambridge, Cambridge, UK.

Keywords

Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Bacterial Proteins, Membrane Transport Proteins, ATP-Binding Cassette Transporters, Drug Resistance, Bacterial, Drug Resistance, Multiple