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Previous studies indicate that quorum sensing contributes to the evolution of bacterial resistance to antibiotics, but the underlying mechanisms are not fully understood. In this study, we grew\n              <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n              in the presence of sub-lethal concentrations of ciprofloxacin, resulting in a large increase in ciprofloxacin minimal inhibitory concentration. We discovered that quorum sensing-mediated phenazine biosynthesis was significantly enhanced in the resistant isolates, where the quinolone circuit was the predominant contributor to this phenomenon. We found that production of pyocyanin changed carbon flux and showed that the effect can be partially inhibited by the addition of pyruvate to cultures. This study illustrates the role of quorum sensing-mediated phenotypic resistance and suggests a strategy for its prevention.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.00118-24","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T12:45:39Z","timestamp":1711370739000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":16,"title":["Quorum-sensing regulation of phenazine production heightens\n            <i>Pseudomonas aeruginosa<\/i>\n            resistance to ciprofloxacin"],"prefix":"10.1128","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1034-8193","authenticated-orcid":false,"given":"Lexin","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4574-508X","authenticated-orcid":false,"given":"Yue","family":"Li","sequence":"additional","affiliation":[{"name":"School of Environmental Science and Engineering, Zhejiang Gongshang University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0799-6988","authenticated-orcid":false,"given":"Yufan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Environmental Science and Engineering, Zhejiang Gongshang University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3169-0510","authenticated-orcid":false,"given":"Hui","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-6523","authenticated-orcid":false,"given":"Ajai A.","family":"Dandekar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Washington, Seattle, Washington, USA"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9867-8984","authenticated-orcid":false,"given":"Meizhen","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Environmental Science and Engineering, Zhejiang Gongshang University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-6628","authenticated-orcid":true,"given":"Feng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","volume-title":"Rev Antimicrob resist","author":"O\u2019Neil J","year":"2014","unstructured":"O\u2019Neil J. 2014. 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