Deletion of porins MspA (MN01) and MspC (ML10) caused a decreased susceptibility to clarithromycin, erythromycin and rifampicin. Deletion of lfrA (XZL1675) increased the susceptibility to ciprofloxacin
and ethambutol (Table 2), which suggests that LfrA might contribute to the intrinsic resistance of M. smegmatis to these drugs, as already reported by other studies [15]. Moreover, the LfrA mutant also showed increased susceptibility to EtBr, thioridazine and verapamil (Table 1). Table 2 Effect of efflux inhibitors on the MICs of antibiotics for wild-type and mutant Navitoclax chemical structure strains of M. smegmatis MICs (mg/L) M. smegmatis strains Antibiotic/EPI mc 2 155 (wild-type) SMR5 (mc 2 155 STR r ) MN01 (SMR5 Δ mspA Ruxolitinib cell line ) ML10 (SMR5 Δ mspA Δ mspC ) XZL1675 (mc 2 155 Δ lfrA ) XZL1720 (mc 2 155 Δ lfrR ) No EPI 0.5 0.5 0.5 0.5 0.5 0.5 AMK CPZ 0.125 0.125 0.125 0.25 0.063 0.063 TZ 0.063 0.063 0.125 0.25 0.063 0.063 VP 0.125 0.125 0.125
0.25 0.125 0.125 No EPI 0.25 0.25 0.25 0.25 0.125 0.125 CIP CPZ 0.063 0.063 0.063 0.063 0.063 0.063 TZ 0.063 0.063 0.063 0.063 0.032 0.032 VP 0.063 0.063 0.063 0.063 0.063 0.063 No EPI 2 2 8 8 2 2 CLT CPZ 0.25 0.25 0.5 1 0.25 0.25 TZ 0.25 0.25 1 1 0.25 0.25 VP 0.5 0.5 0.5 1 0.5 0.5 No EPI 1 1 1 1 0.5 1 EMB CPZ 1 1 1 1 0.5 1 TZ 1 1 1 1 0.5 1 VP 1 1 1 1 0.5 1 No EPI 32 32 64 64 32 32 ERY CPZ 4 4 8 8 4 4 TZ 4 4 16 16 4 4 VP 8 8 8 8 8 8 No EPI 4 4 8 8 0.5 0.5 RIF CPZ 1 1 2 2 0.125 0.125 TZ 2 2 4 4 0.125 0.125 VP 2 2 4 4 0.125 0.25 No EPI 0.5 >256 >256 >256 0.5 0.5 STR CPZ 0.125 >256 >256 >256 0.032 0.063 TZ 0.125 >256 >256 >256 0.125 0.25 VP 0.25 >256 >256 >256 0.25 0.125 AMK, amikacin; CIP, ciprofloxacin; CLT, clarithromycin; CPZ,
chlorpromazine; EMB, ethambutol; EPI, efflux pump Coproporphyrinogen III oxidase inhibitor; ERY, erythromycin; RIF, rifampicin; STR, streptomycin; TZ, thioridazine; VP, verapamil. Data in bold type represents significant (at least 4-fold) reduction of the MIC produced by the presence of an efflux inhibitor. Relatively to the effect of the efflux inhibitors on the MICs of the tested antibiotics, there is an overall reduction of the MICs, with the exception of ethambutol, in all of the studied strains. The fact that the effect of these inhibitors is not dependent of a given genotype suggests that these compounds have a wide range of activity against efflux and are not specific of a particular efflux pump.