PBP occupancy and efflux of β-lactams in clinical isolates of Neisseria gonorrhoeae

This study looked at the connection between the genetic variability of the main β-lactam target (penicillin binding protein 2; PBP2), target accessibility, and susceptibility to last-line antimicrobial class as well as potential new candidates. Genetic analysis found various factors contributing to β-lactam resistance affecting drug targets, entry and efflux.

Specific substitutions in PBP2 were confirmed as the key determinant of cephalosporin resistance with notable impacts on drug sensitivity. Ertapenem and piperacillin emerged as potential therapies against resistant strains along with combination therapies involving tazobactam or efflux inhibitors. The findings provide insights for developing new antimicrobial agents against emerging resistant strains while further research is needed for better therapeutic interventions for these infections.