title: Efflux pumps of Gram-negative bacteria: what they do, how they do it, with what and how to deal with them.
abstract: This review discusses the relationship of the efflux pump (EP) system of Gram-negative bacteria to other antibiotic resistance mechanisms of the bacterium such as quorum sensing, biofilms, two component regulons, etc. The genetic responses of a Gram-negative to an antibiotic that render it immune to an antibiotic are also discussed. Lastly, the methods that have been developed for the identification of bacteria that over-express their EP system are presented in detail. Phenothiazines are well-known antipsychotic drugs with reported activity against bacterial EPs and other ancillary antibiotic mechanisms of the organism. Therefore these compounds will also be discussed.
authors.affiliation: Travel Medicine of the Centro de Malária e Doenças Tropicais, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa Lisbon, Portugal ; Institute of Medical Microbiology and Immunobiology, University of Szeged Szeged, Hungary.
authors.forename: Leonard
authors.initials: L
authors.lastname: Amaral
authors.affiliation: Institute of Medical Microbiology and Immunobiology, University of Szeged Szeged, Hungary ; Unit of Parasitology and Medical Microbiology, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Martins
authors.affiliation: Institute of Medical Microbiology and Immunobiology, University of Szeged Szeged, Hungary.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Spengler
authors.affiliation: Institute of Medical Microbiology and Immunobiology, University of Szeged Szeged, Hungary.
authors.forename: Joseph
authors.initials: J
authors.lastname: Molnar
keywords: Gram-negative bacteria; biofilms; efflux pumps; genetic responses to antibiotic exposure; inhibition; inhibitory agents of efflux pumps and QS; methods for identification of bacteria that over-express efflux pumps; quorum sensing