Antibiotic resistance in Salmonella: Targeting multidrug resistance by understanding efflux pumps, regulators and the inhibitors

Abstract

An increased number of research articles in terms of infectious disease and multidrug resistance challenges reveals that antibiotic resistance is becoming a serious health issue. Multidrug resistance in Salmonella is acquired through efflux pumps extruding the antibiotics from the bacterial cells. Efflux pumps in bacteria help in developing resistance and tolerating antibiotics. A collective effort of efflux pumps, regulators, and other cellular components helps in multidrug resistance, pathogenicity, biofilm formation, etc. As a result, efflux pumps have become an important drug target for novel drugs and their inhibitors may help to fight the resistance to existing antibiotics. Efflux pumps recognize the substrates, and prevent their accumulation inside the cells, thus interrupting their mode of action. Drug resistance in Salmonella is regulated by the expression of transcriptional regulator families. In this review, the different efflux pumps, their regulators, and inhibitors are summarized to target the antibiotic resistance pattern of Salmonella. In addition, a special focus is made to elucidate the roles of Salmonella efflux pumps in virulence and biofilm formation. The detailed study of efflux pump inhibitors may also help to explore and identify novel antibiotic components or additives that enhance the drug efficacy in multidrug-resistant strains.