Importance of the gonococcal MtrCDE efflux pump system in decreasing bacterial susceptibility to zoliflodacin: implications for future clinical treatment of gonorrhea.

Mutations affecting the MtrCDE efflux pump system can decrease gonococcal susceptibility to the FDA-approved antibiotic zoliflodacin, potentially impacting future treatment efficacy.

• Why it matters: The rise of ceftriaxone-resistant Neisseria gonorrhoeae strains highlights the need for new antibiotics, but existing resistance mechanisms may threaten the effectiveness of zoliflodacin, a promising alternative.
• What they did: Researchers studied how mutations in mtrCDE gene expression or activity, along with gyrB mutations, influence gonococcal susceptibility to zoliflodacin, using genetic and microbiological analyses.
• The result: Findings suggest that mutations in mtrCDE and gyrB may reduce zoliflodacin effectiveness, indicating that adjunctive therapies targeting the efflux pump could help preserve its clinical utility.