TY - JOUR A1 - Vareschi, Silvia A1 - Jaut, Valerie A1 - Vijay, Srinivasan A1 - Allen, Rosalind J. A1 - Schreiber, Frank T1 - Antimicrobial efflux and biofilms: an interplay leading to emergent resistance evolution N2 - The biofilm mode of growth and drug efflux are both important factors that impede the treatment of bacterial infections with antimicrobials. Decades of work have uncovered the mechanisms involved in both efflux and biofilm-mediated antimicrobial tolerance, but links between these phenomena have only recently been discovered. Novel findings show how efflux impacts global cellular physiology and antibiotic tolerance, underpinned by phenotypic heterogeneity. In addition efflux can mediate cell-to-cell interactions, relevant in biofilms, via mechanisms including efflux of signaling molecules and metabolites, signaling using pump components and the establishment of local antibiotic gradients via pumping. These recent findings suggest that biofilm antibiotic tolerance and efflux are closely coupled, with synergistic effects leading to the evolution of antimicrobial resistance in the biofilm environment. KW - Evolution KW - Efflux KW - Antibiotics KW - Biofilms KW - Antimicrobial resistance KW - Phenotypic heterogeneity PY - 2025 UR - https://nbn-resolving.org/urn:nbn:de:kobv:b43-632799 DO - https://doi.org/10.1016/j.tim.2025.04.012 SN - 0966-842X SP - 1 EP - 15 PB - Elsevier Ltd. AN - OPUS4-63279 LA - eng AD - Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin, Germany ER -