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Gram-negative bacilli, such as\n              <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n              (\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              ), are notorious for their rapid development of drug resistance, leading to treatment failures. TanReQing injection (TRQ) was chosen to explore its pharmacological mechanisms against clinical multidrug-resistant\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              (MDR-PA), given its antibacterial and anti-inflammatory properties. We revealed the expression of proteins and genes in\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              after co-culture with TRQ. This study developed an assessment method to evaluate clinical resistance of\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              using MALDI-TOF MS identification and Biotyper database searching techniques. Additionally, it combined MIC determination to investigate changes in MDR-PA treated by TRQ. TRQ effectively reduced the MICs of ceftazidime and cefoperazone and enhanced the confidence scores of MDR-PA as identified by mass spectrometry. Using this evaluation method, the fingerprints of standard\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              and MDR-PA were compared, and the characteristic peptide sequence (Seq-PA No. 1) associated with flagellum was found. The phenotypic experiments were conducted to confirm the effect of TRQ on the motility and adhesion of\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              . A combination of co-immunoprecipitation and proteome analysis was employed, and 16 proteins were significantly differentially expressed and identified as potential candidates for investigating the mechanism of inhibiting resistance in\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              treated by TRQ. The candidates were verified by quantitative real-time PCR analysis, and TRQ may affect these core proteins (MexA, MexB, OprM, OprF, OTCase, IDH, and ASL) that influence resistance of\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              . The combination of multiple methods helps elucidate the synergistic mechanism of TRQ in overcoming resistance of\n              <jats:italic>P. aeruginosa<\/jats:italic>\n              .\n            <\/jats:p>\n            <jats:sec>\n              <jats:title>IMPORTANCE<\/jats:title>\n              <jats:p>\n                <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                is an opportunistic pathogen closely associated with various life-threatening acute and chronic infections. The presence of antimicrobial resistance and multidrug resistance in\n                <jats:italic>P. aeruginosa<\/jats:italic>\n                infections significantly complicates antibiotic treatment. The expression of \u03b2-lactamase, efflux systems such as MexAB-OprM, and outer membrane permeability are considered to have the greatest impact on the sensitivity of\n                <jats:italic>P. aeruginosa<\/jats:italic>\n                . The study used a method to assess the clinical resistance of\n                <jats:italic>P. aeruginosa<\/jats:italic>\n                using matrix-assisted laser desorption ionization time of flight mass spectrometry identification and Biotyper database search techniques. TanReQing injection (TRQ) effectively reduced the MICs of ceftazidime and cefoperazone in multidrug-resistant\n                <jats:italic>P. aeruginosa<\/jats:italic>\n                (MDR-PA) and improved the confidence scores for co-cultured MDR-PA. The study found a characteristic peptide sequence for distinguishing whether\n                <jats:italic>P. aeruginosa<\/jats:italic>\n                is resistant. Through co-immunoprecipitation and proteome analysis, we explored the mechanism of TRQ overcoming resistance of\n                <jats:italic>P. aeruginosa<\/jats:italic>\n                .\n              <\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.02726-23","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T14:02:58Z","timestamp":1709128978000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":9,"title":["In-depth analysis of the treatment effect and synergistic mechanism of TanReQing injection on clinical multi-drug resistant\n            <i>Pseudomonas aeruginosa<\/i>"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-2935","authenticated-orcid":false,"given":"Dongying","family":"Li","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on 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Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyu","family":"Cui","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renjing","family":"Su","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of 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