# Ribosomal protection as a linezolid resistance mechanism in Mycobacterium abscessus

## TL;DR

This paper shows how a protein in Mycobacterium abscessus causes resistance to antibiotics like linezolid, which target the bacterial ribosome.

## Contribution

The study identifies MAB_2736c, an ABC-F protein in M. abscessus, as a novel resistance mechanism to ribosome-targeting antibiotics.

## Key findings

- MAB_2736c confers resistance to linezolid, macrolides, and chloramphenicol in Mycobacterium abscessus.
- ABC-F proteins may be a key target for overcoming intrinsic resistance to ribosome-targeting antibiotics in mycobacteria.

## Abstract

Mycobacterium abscessus has emerged as a significant pulmonary pathogen characterized by its resistance to most first-line antimycobacterial drugs. Recent investigations have highlighted the clinical efficacy of including the oxazolidinone antibiotic linezolid in M. abscessus combination therapies, despite moderate resistance frequently being observed in patient isolates. Even with the potential usefulness of linezolid, the mechanisms that drive linezolid resistance in M. abscessus remain poorly understood. In several bacterial pathogens, including Mycobacterium tuberculosis, ATP-binding cassette (ABC) family proteins of the F subtype (ABC-F) have been found to confer antibiotic resistance to ribosome-targeting antibiotics, including linezolid. Here, we identified an M. abscessus ABC-F protein, MAB_2736c, that causes specific resistance to antibiotics that bind the 50S ribosomal subunit, including linezolid, macrolides, and chloramphenicol. These results demonstrate that targeting ABC-F proteins could help combat intrinsic resistance to several ribosome-targeting antibiotics in mycobacteria.