Bile resistance mechanisms in pathogenic bacteria

What is it about?

The ESKAPE pathogens (Enterococcus, Staphylococcus, Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter) are mostly not considered gastrointestinal pathogens. Yet, these pathogens are often isolated from bile and gallbladder-related infections in which many isolates have an antimicrobial phenotypes. This review explores how mechanisms like efflux pumps and biofilm formation enable pathogens to resist both bile and antibiotics. It also highlights a need for additional research how bile affects survival and pathogenesis of the ESKAPE pathogens. Coupled with observations in traditional enteric pathogens in which an update is provided, efflux pumps, outer surface changes, and biofilm formation are a conserved pathogen response to bile.

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Why is it important?

The prevalence and growth of antimicrobial resistance in bacterial pathogens is staggering. This review discusses how pathogens use the same mechanisms to resist bile and antibiotics, and highlights the need for future research that includes important considerations for future therapeutic development.

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