ABSTRACT
During a screen of Neisseria gonorrhoeae clinical isolates obtained in Uruguay for susceptibility to azithromycin, we noticed that approximately 10% of the strains examined displayed decreased susceptibility to azithromycin and erythromycin due to the mtr(CDE)-encoded efflux pump system, but remained susceptible to Triton X-100. We now report that the mtr(R) promoter region of one of these isolates contains a dinucleotide insertion (TT) that mediates this resistance phenotype.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacterial Proteins , Drug Resistance, Multiple/genetics , Ferredoxin-NADP Reductase , Neisseria gonorrhoeae/genetics , Promoter Regions, Genetic/genetics , Repressor Proteins/genetics , Azithromycin/pharmacology , DNA, Bacterial/analysis , Drug Resistance, Microbial/genetics , Erythromycin/pharmacology , Gene Expression , Humans , Male , Mutation , Neisseria gonorrhoeae/drug effectsABSTRACT
Efflux pumps can make a significant contribution to the capacity of bacteria to resist the action of antibiotics. Certain efflux pumps also recognize antimicrobial agents that are present in their respective hosts and their ability to export toxic agents could enhance bacterial survival during infection prior to appearance of cellular or humoral host defensive systems. This review is concerned with the principal efflux pumps possessed by two closely related strict human pathogens, Neisseria gonorrhoeae and Neisseria meningitidis. Specific emphasis is placed on the organization of the structural genes encoding the mtr and far efflux pumps, the substrates (often host-derived) recognized by these pumps, and the cis- and trans-acting transcriptional factors that regulate efflux pump gene expression in gonococci and meningococci. The overriding theme of this review is that the efflux pumps possessed by these pathogens likely contribute to their pathogenic mechanisms by providing a means to escape a number of antimicrobial compounds that bathe mucosal surfaces.
