Efflux Pumps in Mycobacteria: Antimicrobial Resistance, Physiological Functions, and Role in Pathogenicity

PE Almeida da Silva, Diana Isabel Oliveira Machado, D Ramos, I Couto, A Von Groll, M Viveiros

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


The emergence of multidrug and extensively drug-resistant tuberculosis represents a major threat to the control of the disease. Antimicrobial drug resistance in Mycobacterium tuberculosis is not merely a consequence of the occurrence of gene mutations in the drug targets but a balance between the acquisition of mutations and drug efflux. The low permeability of the mycobacterial cell wall acts synergistically with active drug efflux pumps, and this combined mechanism may particularly constitute the first step for the development of drug resistance. Besides drug efflux, efflux pumps also have physiological functions in the bacteria, and their expression is subjected to tight regulation in response to multiple environmental and physiological signals. Understanding the mechanisms underlying drug efflux, efflux pump regulation and their contribution for pathogenicity not only enables the development of more rapid and accurate tools for the guidance of antituberculosis therapy but also provides knowledge for the development of new therapeutic strategies.
Original languageEnglish
Title of host publicationEfflux-Mediated Antimicrobial Resistance in Bacteria
Subtitle of host publicationMechanisms, Regulation and Clinical Implications
PublisherSpringer International Publishing Switzerland
ISBN (Print)978-3-319-39656-9
Publication statusPublished - 2016


  • Mycobacteria
  • Tuberculosis
  • Multidrug resistance
  • Efflux
  • Efflux pump inhibitor
  • Fitness
  • Pathogenicity


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