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Expression of many virulence factors in P. aeruginosa is regulated by a cell density dependent mechanism called quorum sensing. Quorum sensing allows P. aeruginosa to sense the density of the surrounding bacterial population and to coordinately regulate transcription of various virulence genes. Pseucomonas aeruginosa is a common pathogen infecting chronic respiratory infections, such as diffuse panbronchiolitis (DPB) patients. Although these patients are typically treated with multiple anti-pseudomonal antibiotics, the infection is rarely eradicated and often results in mortality. In the 1980s it was reported that long-term therapy with low doses of erythromycin improved the clinical symptoms of DPB patients colonized with P. qeruginosa. Recently it has been demonstrated that sub MIC concentrations of macrolides strongly inhibite Pseudomonas quorum sensing system. These data suggested a novel mechanism of quorum sensing regulation of antibiotic sensitivity.

Quorum sensing : The possibility of the new antibiotic target in bacterial infection