Methicillin-resistant Staphylococcus aureus (MRSA) efflux pump inhibitors from natural products

Among different nosocomial infections, Staphylococcus aureus, a Gram-positive bacterium, is a highly adaptive human pathogen. Over the years it had acquired resistance to multiple classes of antibiotics including methicillin. The multidrug resistance towards multiple antibiotics and poor pipeline of safe and effective drugs has rendered bacterial infections a life-threatening problem. Multidrug efflux pumps play an essential role in antibiotic resistance by extrusion of drugs via different mechanisms. Natural products especially derived from plants have emerged as an important source of effective efflux pump inhibitors. In this article different classes of plant- and microbe-derived natural products have been described as efflux pump inhibitors of MRSA that act synergistically in combination with antibiotics to modulate efflux pump-mediated extrusion of antibiotics and thereby help in combating the multidrug resistance