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Title: Enhanced active efflux, repression of porin synthesis and development of Mar phenotype by diazepam in two enterobacteria strains
Authors: Tavío, María M. 
Vila, Jordi
Perilli, Mariagrazia
Casañas, Lucia T.
Maciá, Laura
Amicosante, Gianfranco
Jiménez De Anta, María T.
Keywords: Multiple Antibiotic-Resistance
Energy-Dependent Accumulation
Fluoroquinolone Resistance, et al
Issue Date: 2004
Publisher: 0022-2615
Journal: Journal of Medical Microbiology 
Abstract: The aim of this work was to determine whether diazepam could induce the multiple antibiotic resistance (Mar) phenotype in Klebsiella pneumoniae and Escherichia coli strains. The Mar phenotype is characterized by decreased susceptibility to multiple antibiotics due to the loss of porins and/or increased expression of active efflux systems. The effect of subinhibitory concentrations of diazepam on the susceptibility of different antimicrobial agents, outer-membrane protein expression and norfloxacin intracellular accumulation was studied. The results revealed that diazepam concentrations equal or twice adult dosage induced the same Mar phenotype as two well known E coli marRAB inducers, sodium salicylate and sodium benzoate. Susceptibility to norfloxacin in a K pneumoniae clinical isolate and E coli strain Ag100 decreased due to enhanced active efflux and loss of porin expression. A decreased susceptibility to chloramphenicol, tetracycline, nalidixic acid and beta-lactam antibiotics was also observed. In conclusion, like sodium salicylate or sodium benzoate, diazepam may induce the Mar phenotype.
ISSN: 0022-2615
DOI: 10.1099/jmm.0.45613-0
Source: Journal of Medical Microbiology[ISSN 0022-2615],v. 53, p. 1119-1122
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