Impeding efflux-mediated resistance in Staphylococcus aureus

Staphylococcus aureus is one of the most common human pathogens that causes wide range of nosocomial and community acquired infections as wound and burn infections, food poisoning, endocarditis, pneumonia, meningitis and bacteremia. Beside its pathogenicity, it exhibits different antibiotic resistance mechanisms that complicate its treatment. Efflux is one of the resistance mechanisms that is used by bacterial pathogens to extrude antimicrobials as antibiotics and biocides and thus counteract their actions. Therefore, there is an urgent need for searching for compounds that have an efflux-inhibitory activity among the existing pharmaceuticals and the compounds that are isolated from natural sources or the synthesis of novel derivatives to be able to treat S. aureus infections. Several efflux pump inhibitors have been identified or synthesized over the past years. In this review, we present the different compounds that have been proven to have an efflux-inhibitory activity against S. aureus and the current progress in their development.