Efflux Pumps As Interventions To Control Infection Caused By Drug-Resistance Bacteria

Bacterial multidrug resistance (MDR) has become a major public health threat. Along with enzymatic modifications, overexpression of MDR efflux pumps is a significant antibiotic resistance mechanism. Efflux pumps are the main mediators of resistance mechanisms to many classes of drug and biofilm structure. Identification of natural substrates and inhibitors is an emerging research discipline. Efflux pump inhibition enables drug accumulation inside bacterial cells, allowing more effective delivery to the intended targets, potentially enhancing the antibacterial action. In this review, we highlight the role of efflux pumps and natural molecules as their inhibitors, both in Gram-positive and Gram-negative bacteria. We also discuss the structure of the AcrAB-TolC efflux pump in Enterobacteriaceae, its mechanisms of action and antibiotic synergetic effects with natural molecules.