The Role of Efflux Pumps in Multidrug Resistance of Pseudomonas aeruginosa Clinical Isolates and the Challenges of Controlling Nosocomial Infections

Pseudomonas aeruginosa remains a formidable pathogen in clinical settings, particularly due to its intrinsic and acquired resistance to a wide range of antibiotics. Among the various mechanisms driving this resistance, the overexpression of Resistance-Nodulation-Division (RND) efflux pumps is increasingly recognized as a critical factor in multidrug resistance (MDR). This review synthesizes current literature regarding the molecular mechanisms of major RND efflux systems, specifically MexAB-OprM, MexCD-OprJ, and MexXY-OprM, and their clinical implications in nosocomial infections. Furthermore, it addresses the challenges posed by these efflux systems in antibiotic therapeutic failure and critically evaluates the current status of efflux pump inhibitors (EPIs) as a promising therapeutic strategy. By highlighting the interplay between regulatory mutations and pump expression, this article provides a comprehensive overview for clinicians and researchers aiming to mitigate the burden of MDR P. aeruginosa.

کلیدواژه ها:

Pseudomonas aeruginosa ، Efflux Pumps ، Multidrug Resistance (MDR) ، Nosocomial Infections ، RND family ، Therapeutic Strategies