Multidrug resistance pumps as a keystone of bacterial resistance

Abstract

Antibiotic resistance is a global problem of modern medicine. A harbinger of the onset of the post-antibiotic era is the complexity and high cost of developing new antibiotics, as well as their ineffi ciency due to the rapidly developing resistance of bacteria. The cornerstone of bacterial protection against antibiotics are multidrug resistance pumps (MDR), which are involved in the formation of resistance to xenobiotics, the export of toxins, the maintenance of cellular homeostasis, the formation of biofilms and persistent cells. MDR pumps are the basis for the nonspecific protection of bacteria, while modification of the drug target, inactivation of the drug, switching of the target or sequestration of the target is the second, specific line of their protection. Thus, the nonspecific protection of bacteria formed by MDR pumps is a barrier that prevents the penetration of antibacterial substances into the cell, which is the main factor determining the resistance of bacteria. Understanding the mechanisms of MDR pumps and a balanced assessment of their contribution to overall resistance, as well as to antibiotic sensitivity, will either seriously delay the onset of the post-antibiotic era, or prevent its onset in the foreseeable future