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The MexA-MexB-OprM efflux pump of Pseudomonas aeruginosa consists of two inner membrane proteins, MexA and MexB, and one outer membrane protein, OprM. We investigated the role of the components of this drug extrusion system by evaluating the repercussions of deleting these subunit components on the accumulation of several fluorescent probes. Fluorescence intensities of positively charged 2-(4-dimethylaminostyryl)-1-ethylpyridinium and uncharged N-phenyl-1-naphtylamine were 7 and 4 times higher, respectively, in the mutant lacking OprM and 4 and 1.7 times higher, respectively, in the mutants lacking MexA or MexB than in the wild type strain. This order of fluorescence intensity was fully consistent with a previously reported minimum inhibitory concentration of antibiotics such as tetracycline, chloramphenicol, and fluoroquinolones. Ethidium bromide accumulation in all the Mex mutants proceeded at about 5 times faster than the rate in the wild type cells. This result is in accord with the minimum inhibitory concentration of ␤-lactam antibiotics. These results suggest that the fluorescence probes could be successfully used in real time monitoring of the function of the drug extrusion machinery in Gram-negative bacteria. The downhill extrusion kinetics of 1-(4-trimethylammoniumphenyl)-6-phenyl-1,3,5-hexatriene, which orients perpendicular to the inner leaflet of the cytoplasmic membrane, from preloaded cells lacking the extrusion pump was preceded by a slow increase in fluorescence intensity, whereas the wild type cell immediately released the dye. This observation was explained by a slow trans-cytoplasmic membrane crossing of intracellular dye in the mutants. These results reflected higher accumulation of the probe in the cytoplasmic membrane in the mutants and strengthened the hypothesis that extrusion of hydrophobic substrate mediated by MexA-MexB-OprM mainly takes place from the interior of the cytoplasmic membrane.Multiple antibiotic resistance in bacteria has been associated with the overexpression of endogenous efflux genes (for reviews see Refs. 1 and 2). In Pseudomonas aeruginosa, active extrusion (3, 4) combined with a tight diffusion barrier at the outer membrane (5, 6) are the main reasons for low specific resistance against diverse antibiotics and other toxic elements (7).Multidrug resistance in P. aeruginosa is now attributed mainly to the overexpression of three sets of operons. Overexpression of the operon mexA-mexB-oprM is characteristic for nalB type multidrug-resistant mutants, (8, 9), whereas overexpression of the operon mexC-mexD-oprJ (10) is responsible for multidrug resistance in nfxB type mutants (11). A third type designated as nfxC has also been associated with a diminished intracellular drug accumulation (12). The genes coding for the proteins involved in the drug extrusion have been characterized recently (13) and named mexE-mexF-oprN.A common characteristic of multiantibiotic-resistant mutants in P. aeruginosa is their broad resistance to quinolones, and hence one method generally used t...

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