The chromosomally encoded Qnr homolog protein from Enterococcus faecalis (EfsQnr), when expressed, confers to its host a decreased susceptibility to quinolones and consists mainly of tandem repeats, which is consistent with belonging to the pentapeptide repeat family of proteins (PRPs). EfsQnr was cloned with an N-terminal 6؋ His tag and purified to homogeneity. EfsQnr partially protected DNA gyrase from fluoroquinolone inhibition at concentrations as low as 20 nM. EfsQnr inhibited the ATP-dependent supercoiling activity of DNA gyrase with a 50% inhibitory concentration (IC 50 ) of 1.2 M, while no significant inhibition of ATP-independent relaxation activity was observed. EfsQnr was cytotoxic when overexpressed in Escherichia coli, resulting in the clumping of cells and a loss of viability. The X-ray crystal structure of EfsQnr was determined to 1.6-Å resolution. EfsQnr exhibits the right-handed quadrilateral beta-helical fold typical of PRPs, with features more analogous to MfpA (mycobacterium fluoroquinolone resistance pentapeptide) than to the PRPs commonly found in cyanobacteria.Quinolones are broad-spectrum synthetic antibacterials used extensively in the treatment of a variety of bacterial infections (14). They exert their powerful bactericidal activity by interacting with type II topoisomerases, namely, DNA gyrase and DNA topoisomerase IV. Type II topoisomerases cleave both strands of DNA during the catalytic cycle and allow the passage of a double-stranded segment of the same DNA molecule or of another molecule through the open gate before the original strands are religated. Quinolones stabilize the transient cleavage complex and block the religation; the subsequent hydrolysis of the enzyme-DNA bond results in the release of lethal double-stranded DNA breaks (9,13,17,21). Gyrase is responsible for introducing and maintaining negative supercoils. Gyrase also can remove both positive and negative supercoils and catenate/decatenate closed-circular DNA molecules. Topoisomerase IV also removes both negative and positive supercoils and catalyzes decatenation more efficiently than gyrase; however, it lacks the ability to introduce supercoils into DNA. These two enzymes work together in the replication, transcription, and repair of DNA (6).Bacteria have developed a variety of resistance mechanisms to evade the bactericidal effect of quinolones. Chromosomal mutations of the target gene resulting in amino acid substitution(s) in gyrase and/or topoisomerase IV have been the most clinically significant resistance mechanism (8, 14-16) before the recent emergence of horizontally transmissible plasmidmediated quinolone resistance (PMQR) (19,22,24,26,37,43,44, and references therein), although other resistance mechanisms, such as decreased intracellular accumulation due to active efflux either alone or together with the decreased expression of outer membrane porins, have been described already (7,23,25,27,36). PMQR, first described in 1998 in an isolate of Klebsiella pneumoniae (28), was found to be due to a gene named ...