Role Of Efflux Pump Genes In Antibiotic Resistance of Klebsiella pneumoniae Bacteria Isolated From Clinical Causes: A Narrative Review

Klebsiella pneumoniae is an opportunistic pathogen, mostly affecting those with weakened immune systems and immune-compromised and cause nosocomial infections. Which are commonly acquired in hospitals Pathogens causing acute respiratory infections such as Pneumonia. Other infections caused by this organism include urinary tract infections, wound infections Abscesses, sepsis, inflammation, and diarrhea. Klebsiella pneumoniae have a range of virulence factors to colonize and replicate in the host cell. These include at least surface antigen, especially capsular polysaccharide (CPS) (K antigen); siderophores responsible for binding ferric iron secreted by host iron-binding proteins; and adherence variants responsible for binding to host cell surfaces, such as type 1 and type 3 fimbriae, and non-fimbrian adherence proteins. Antibiotic resistance leads to more effects of this infection. Antibiotic resistance of K. pneumoniae to carbapenems is mediated by a number of mechanisms, including the production of potent carbapenems, as well as beta-lactamases with weak carbapenemase activity in association with membrane permeabilization. Colistin is widely viewed as the last line of defense against KPC-producing K. pneumoniae, but reports of colistin-resistant Klebsiella isolates are on the rise. The effect of antibiotics to kill bacterial cells is mainly based on the inhibition of some cellular function through a drug-target interaction. The main specific targets of antibiotics are cell wall synthesis, cell membrane, nucleic acid (DNA and RNA), and protein and folate synthesis. Efflux pumps reduce the drug concentration without modifying the antibiotic itself. Decreased outer membrane permeability results in a decrease in the efflux of antimicrobial agents. Therefore, this causes resistance in many important clinical microorganisms. This type of resistance is controlled by plasmids or chromosomes. Efflux pumps are resistance mechanisms used in many bacteria to certain antibiotics of different classes, such as tetracyclines, beta-lactams, macrolides, aminoglycosides, streptogramins, lincosamides, phencols, oxazolidinones, pyrimidines, quinolones, rifamycins, sulfonamides and cationic peptides. Although resistance to a range of antimicrobial agents in Gram-negative bacteria was previously attributed to the structure and function of the outer membrane.