Cytotoxic factor influencing acquired antimicrobial resistance in Pseudomonas aeruginosa

The Gram-negative opportunistic bacterium Pseudomonas aeruginosa is associated with different types of human infections and because of emerging multidrug-resistant strains, these infections are of major global public health concern. Certain strains possess a unique cytotoxic effector protein ExoU, which contributes to the fitness of this organism in different ecological niches and is associated with acquired antibiotic resistance. This article summarises the current knowledge of the exoU gene in P. aeruginosa, including genetics, distribution in strains from different locations and association with antibiotic resistance. Understanding of this effector protein may have important implications for the understanding of pathogenesis and antimicrobial resistance in P. aeruginosa infections.