Multidrug-resistance efflux pumps - not just for resistance

Nat Rev Microbiol. 2006 Aug;4(8):629-36. doi: 10.1038/nrmicro1464.


It is well established that multidrug-resistance efflux pumps encoded by bacteria can confer clinically relevant resistance to antibiotics. It is now understood that these efflux pumps also have a physiological role(s). They can confer resistance to natural substances produced by the host, including bile, hormones and host-defence molecules. In addition, some efflux pumps of the resistance nodulation division (RND) family have been shown to have a role in the colonization and the persistence of bacteria in the host. Here, I present the accumulating evidence that multidrug-resistance efflux pumps have roles in bacterial pathogenicity and propose that these pumps therefore have greater clinical relevance than is usually attributed to them.

Publication types

  • Review

MeSH terms

  • ATP-Binding Cassette Transporters / physiology
  • Bacteria / pathogenicity*
  • Bacterial Outer Membrane Proteins / physiology
  • Bacterial Physiological Phenomena*
  • Bacterial Proteins / physiology
  • Carrier Proteins / physiology
  • Drug Resistance, Multiple, Bacterial / physiology*
  • Escherichia coli Proteins / physiology
  • Membrane Transport Proteins / physiology
  • Microbial Sensitivity Tests
  • Multidrug Resistance-Associated Proteins / genetics*
  • Virulence / physiology


  • ATP-Binding Cassette Transporters
  • AcrAB-TolC protein, Salmonella enterica
  • Bacterial Outer Membrane Proteins
  • Bacterial Proteins
  • Carrier Proteins
  • Escherichia coli Proteins
  • Membrane Transport Proteins
  • MexA protein, Pseudomonas aeruginosa
  • MexB protein, Pseudomonas aeruginosa
  • Multidrug Resistance-Associated Proteins
  • tolC protein, E coli