Efflux Pump Mediated Second-Line Tuberculosis Drug Resistance

The burden and spread of drug-resistant tuberculosis disease is a major public health problem worldwide. The causative agent, Mycobacterium tuberculosis uses several mechanisms to counteract therapy through drugresistance. A major and most common mechanism of drug-resistance is mediated through target mutations. Efflux pumps are emerging as potential agents of drug-resistance and treatment failure. In this review we explore the origin and principles of efflux pump-mediated resistance and determine their impact on second-line drugs used against extensively drug resistant tuberculosis. Inhibition of efflux pumps as a therapeutic intervention is also discussed.