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Abstract
<p class="first" id="d10185664e77">The antibiotic ciprofloxacin is used extensively
to treat a wide range of infections
caused by the opportunistic pathogen Pseudomonas aeruginosa. Due to its extensive
use, the proportion of ciprofloxacin-resistant P. aeruginosa isolates is rapidly increasing.
Ciprofloxacin resistance can arise through the acquisition of mutations in genes encoding
the target proteins of ciprofloxacin and regulators of efflux pumps, which leads to
overexpression of these pumps. However, understanding of the basis of ciprofloxacin
resistance is not yet complete. Recent advances using high-throughput screens and
experimental evolution combined with whole-genome sequencing and protein analysis
are enhancing our understanding of the genetic and biochemical mechanisms involved
in ciprofloxacin resistance. Better insights into the mechanisms of ciprofloxacin
resistance may facilitate the development of new or improved therapeutic regimes effective
against P. aeruginosa. In this review we discuss the current understanding of the
mechanisms of ciprofloxacin resistance and summarize the genetic basis of ciprofloxacin
resistance in P. aeruginosa, in the context of current and future use of this antibiotic.
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