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Enhancing the Antibacterial Activity of Ciprofloxacin Against Klebsiella pneumoniae by Inhibiting the AcrAB-TolC Efflux Pump System Using Phenylalanine-arginine β-Naphthylamide
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Background: Klebsiella pneumoniae shows varying degrees of resistance to antibiotic treatment; this resistance arises from multiple mechanisms, including the increased expression of multidrug (MDR) efflux pumps. An efflux pump inhibitor (EPI) is required to overcome this challenge and restore the effectiveness of antibiotics against the present MDR K. pneumoniae. Objective: To investigate the synergistic effect of the EPI Phenylalanine-Arginine β-Naphthylamide (PaβN) and Ciprofloxacin (CIP) on the expression of efflux pump genes AcrAB-TolC, isolated from CIP-resistant K. pneumoniae. Methods: 50 isolates of K. pneumoniae were collected from five different hospitals in Baghdad, Iraq. The minimum inhibitory concentration (MIC) values were determined for the CIP and CIP and PaßN combination using the broth micro-dilution method conducted on ten isolates resistant to CIP. Moreover, the expression level of AcrA, AcrB, and TolC genes from four selected isolates of K. pneumoniae were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Results: K. pneumoniae isolates showed that 40/50 (80%) were multidrug-resistant, and 54% of isolates were resistant to CIP. The MIC was reduced significantly from 2–8-fold in the isolates treated with PaβN and CIP compared to the CIP-treated group. The gene expression levels varied among the four selected isolates, with a slight decrease in AcrAB-TolC gene expression in some isolates treated with the CIP and PaβN combination compared to those treated with CIP alone. Conclusions: The promising finding is the effectiveness of synergistic combinations between the antibiotic and efflux pump inhibitors in eliminating resistance of MDR bacteria.

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Publication Date
Sun Mar 01 2026
Journal Name
Iraqi Journal Of Biotechnology
Detection of acrAB, TolC, mdtk genes and biofilm forming in Klebsiella pneumoniae isolated from different cases
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Publication Date
Tue Jul 09 2019
Journal Name
Global Journal Of Public Health Medicine
IMPROVING THE ANTIBACTERIAL ACTIVITY BY THE COMBINATION OF ZIRCONIUM OXIDE NANOPARTICLES (ZrO2) AND CEFTAZIDIME AGAINST KLEBSIELLA PNEUMONIAE
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Klebsilla pneumoniae is one of must opportunistic pathogens that causes nosocomial infection, UTI, respiratory tract infections and blood infections. ZrO2 nanoparticles have antimicrobial activity against some pathogenic bacteria and fungi. Ceftazidime is one of third generation cephalosporins groups of antibiotecs, characterized by its broad spectrum on bacteria in general and particularly on Enterobacteriaceae family like Klebsiella spp. Method: Diverse clinical samples of Klebsilla pneumoniae were isolated from several hospitals in Baghdad – Iraq and ZrO2 nanoparticles was investigated against it. Ceftazidime was also investigated against K. pneumoniae. Both of ZrO2 nanoparticles and ceftazidime were mixed together and investigated aga

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Publication Date
Thu Jan 01 2026
Journal Name
Iraqi Journal Of Science
Impact the Some Antibiotic on Gene Expression Efflux Pump of Klebsiella pneumoniae Isolated from Clinical Sources
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Publication Date
Fri Jun 23 2023
Journal Name
Journal Of Communicable Diseases
Downregulation of the Gene Expression of Efflux Pump Gene (acrA) and its Regulator (ramA) in Klebsiella pneumoniae by Quaternary Ammonium Compounds
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Introduction: Biocides are commonly used for disinfection in a variety of contexts. They are generally used to avoid infection by controlling biofilm on medical equipment. However, the literature lacks information on the effect of biocide on efflux pump gene expression. Objective: To determine the influence of biocide on biofilm development and efflux pump acrA and ramA gene expression. Methodology: The microtiter plate method was used to identify biofilm development in 80 isolates of K. pneumoniae. The minimal inhibitory concentrations (MIC) of three biocides (quaternary ammonium compound (QAC), chlorohexidine digluconate, and chloroxylenol) were estimated. The effect of QAC on the intensity and viability of biofilms was investigated as we

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Publication Date
Wed Jan 01 2025
Journal Name
Academic Science Journal
Role of efflux pump genes in the antibiotic resistance of Klebsiella pneumoniae bacteria isolated from clinical cases: A Review Paper
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Publication Date
Sun Mar 01 2026
Journal Name
American Institute Of Physics
RAPD Typing of multidrug-resistant Klebsiella pneumonia possessing OqxA and OqxB Efflux pump genes
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Publication Date
Wed Sep 17 2025
Journal Name
Molecular Biology Reports
Antibacterial effect and MexA efflux pump Inhibition by green-synthesized copper nanoparticles from Mentha piperita
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Publication Date
Sat Dec 31 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE ROLE OF EFFLUX PUMP FOR ANTIBIOTIC RESISTANCE IN BACTERIA: THE ROLE OF EFFLUX PUMP FOR ANTIBIOTIC RESISTANCE IN BACTERIA
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ABSTRACT                

The multi-drug resistant efflux pump is a glycoprotein pump whose function is to push foreign substances. The efflux pump is found in humans, animals. It also has wide-ranging properties in  bacteria and fungi. They are found in all species of bacteria, and efflux pump genes can be found in bacterial chromosomes or mobile genetic elements, such as plasmids. The most sensitive function that leads to a global problem is its resistance to antibiotics in bacterial cells, which increases the ability to bacteria from becoming strong virulence factors that most or all antibiotics cannot kill. It also has othe

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Publication Date
Fri Nov 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Prevalence of β-lactam Resistant Klebsiella Pneumoniae Isolates among Clinical Specimensin Baghdad Hospitals
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One hundred forty three of Klebsiellapneumoniae isolates had been collected from some hospitals in Baghdad city. The isolates were taken from different clinical specimens.Antimicrobial susceptibility test was carried out towards fifteen antimicrobial agents by using Vitek2 system with Antimicrobial susceptibility test cards. The results of antibiogram showed that the local isolates were possess highly resistance towards most antimicrobial agents under study. The high resistance wastoAmpicillin while the low resistance was to Imipenem.Two methods were used for detection of Extended Spectrum Beta Lactamases (ESBLs) production; first methods by using of Vitek2 system,thesecondmethods by using of polymerase chain reaction (PCR) technique to dis

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Antibacterial Activity of Synergistic Effect of colicin and Gold Nanoparticles against <i>Klebsiella pneumonia</i>
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