Quinolone and Macrolide Resistance in Campylobacter jejuni and C. coli: Resistance Mechanisms and Trends in Human Isolates

Engberg, Jørgen; Aarestrup, Frank Møller; Taylor, Diane E.; Gerner‐Smidt, Peter; Nachamkin, Irving

doi:10.3201/eid0701.010104

Cited by 612 publications

(536 citation statements)

References 66 publications

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“…Since the 1990s, a significant increase in the prevalence of resistance to macrolides and fluoroquinolones among Campylobacter spp. have been reported and this is recognised as an emerging public health problem in many European countries [40]. Entry of these isolates into the food chain could represent a significant threat to public health.…”

Section: Antibiotic Resistancementioning

confidence: 99%

“…Antibiotics of the macrolide-lincosamide group have been used in treating food animals worldwide for several decades. Their uses have included the control of dysentery and Mycoplasma infections in swine, and for treating mastitis in cattle [40]. The use of macrolides and other compounds for growth promotion has been banned, in all European Union countries with effect from July 1999.…”

Section: Surveillance Of Antimicrobial Resistance In Campylobacter Sppmentioning

confidence: 99%

“…Resistance to erythromycin is mainly found in strains of animal origin, especially C. coli in pigs and from chickens [40] and detection of erythromycin resistance may be determined by PCR methods [163]. Nevertheless, erythromycin is considered to be one of the safest drugs effective against Campylobacter.…”

Section: Genetic Mechanisms Associatedmentioning

confidence: 99%

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Campylobacter

et al. 2005

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-Species within the genus, Campylobacter, have emerged over the last three decades as significant clinical pathogens, particularly of human public health concern, where the majority of acute bacterial enteritis in the Western world is due to these organisms. Of particular concern are the species, C. jejuni and C. coli, which are responsible for most of these gastrointestinal-related infections. Although these organisms have already emerged as causative agents of zoonoses, several aspects of their epidemiology and pathophysiology are only beginning to emerge. Trends in increasing antibiotic resistance are beginning to emerge with oral antibiotics, which may be the drug of choice for when it is necessary to intervene chemotherapeutically. This review wishes to examine (i) emerging clinical aspects of the disease, such as Guillain Barré syndrome (GBS), (ii) the association between these organisms and poultry as a natural host, (iii) environmental aspects of Campylobacter epidemiology, (iv) the emergence of atypical campylobacters (v) emerging trends in antibiotic resistance, (vi) adoption of modern methods for the detection of campylobacters.

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Section: Antibiotic Resistancementioning

confidence: 99%

Section: Surveillance Of Antimicrobial Resistance In Campylobacter Sppmentioning

confidence: 99%

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Campylobacter

et al. 2005

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“…Resistance is commonly due to point mutations in the quinolone resistance determinant region (QRDR) of the gyrase A (gyrA) gene involving the Thr-86 for high, and the Asp-90 and Ala-70 amino acid residues for lower-level resistance (Engberg et al, 2001). …”

Section: Introductionmentioning

confidence: 99%

High level of ciprofloxacin resistance and its molecular background among Campylobacter jejuni strains isolated in the United Arab Emirates

Sonnevend

Rotimi

Kolodziejek

et al. 2006

Journal of Medical Microbiology

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The antibiotic sensitivity and the serotype and molecular type (MT) distribution of 41 Campylobacter jejuni strains isolated from individual patients in Tawam Hospital, Al Ain, United Arab Emirates, were investigated. While all strains were sensitive to erythromycin (MIC 0?5-4 mg l "1 ), 35 isolates (85?4 %) exhibited resistance to ciprofloxacin (MIC 8-64 mg l "1 ). All resistant strains carried the Thr-86 to Ile mutation in the gyrase A (gyrA) gene, as shown by mismatch amplification mutation assay (MAMA) and confirmed by sequencing. Based on the partial sequences of gyrA, resistant isolates carried 10 distinct alleles, eight of them representing new variants. Strains were assigned to 30 MTs based on the combined results of PFGE and flaA PCR-RFLP typing. Eight of the 35 ciprofloxacin-resistant strains, isolated over a period of more than 1 year, represented the largest MT, also carrying the same allelic variant of the gyrA gene. These results show that the local incidence of fluoroquinolone resistance among C. jejuni is one of the highest reported worldwide. It was also demonstrated that stable MTs could persist for a relatively long time among the clonally unrelated antibiotic-resistant isolates of C. jejuni. The data also emphasize the need to replace fluoroquinolones as empirical therapy for diarrhoea of undiagnosed aetiology. INTRODUCTIONFluoroquinolone resistance in Campylobacter jejuni, a leading cause of gastrointestinal infections worldwide and one of the most important causes of travellers' diarrhoea, is rapidly increasing. Resistance is commonly due to point mutations in the quinolone resistance determinant region (QRDR) of the gyrase A (gyrA) gene involving the Thr-86 for high, and the Asp-90 and Ala-70 amino acid residues for lower-level resistance (Engberg et al., 2001).While C. jejuni infections usually present as acute selflimiting gastrointestinal illnesses, in severe or prolonged cases antibiotic therapy is indicated, with macrolides as the primary drug of choice (Butzler, 2004). However, particularly if the causative agent is not identified, as is often the case in travellers' diarrhoea, fluoroquinolones are frequently used empirically (Guerrant et al., 2001;Yates, 2005). In such cases, resistance to ciprofloxacin can result in therapeutic failure (Guerrant et al., 2001;Sanders et al., 2002). Moreover, by mechanisms yet to be elucidated, fluoroquinolone resistance appears to coincide with increased fitness of the organism. In humans, fluoroquinolone-resistant strains are shed longer than sensitive isolates (Nelson et al., 2004;Engberg et al., 2004), and they have been reported to out-compete their sensitive counterparts, at least in certain genetic backgrounds, when colonizing poultry, i.e. the natural reservoir of the pathogen (Luo et al., 2005). All these findings underscore the necessity for close monitoring of the incidence and spread of fluoroquinolone-resistant clones of C. jejuni. Campylobacter isolates recovered from the 3389 stool samples tested during this period of time. Seven of th...

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“…Fluoroquinolones are no longer recommended for the treatment of Campylobacter infection due to the increasing prevalence of fluoroquinolone resistance among human clinical strains (11,28). Erythromycin has been shown to be effective in treating patients with Campylobacter enteritis (30) and is the current drug of choice when antibiotic treatment is indicated.…”

mentioning

confidence: 99%

The Absence of Intervening Sequences in 23S rRNA Genes of Campylobacter coli Isolates from Turkeys Is a Unique Attribute of a Cluster of Related Strains Which Also Lack Resistance to Erythromycin

Chan

Miller

Mandrell

et al. 2007

Appl Environ Microbiol

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Certain Campylobacter strains harbor a transcribed intervening sequence (IVS) in their 23S rRNA genes. Following transcription, the IVS is excised, leading to fragmentation of the 23S rRNA. The origin and possible functions of the IVS are unknown. Furthermore, the distribution of IVS-harboring strains within Campylobacter populations is poorly understood. In this study, 104 strains of Campylobacter coli from turkeys, representing 27 different multilocus sequence typing-based sequence types (STs), were characterized in terms of IVS content and erythromycin susceptibility. Sixty-nine strains harbored IVSs in all three 23S rRNA genes, whereas the other 35 strains lacked IVSs from at least one of the genes. The STs of the latter strains belonged to an unusual cluster of C. coli STs (cluster II), earlier found primarily in turkey strains and characterized by the presence of the C. jejuni aspA103 allele. The majority (66/69) of strains harboring IVSs in all three 23S rRNA genes were resistant to erythromycin, whereas none of the 35 strains with at least one IVS-free 23S rRNA gene were resistant. Cluster II strains could be transformed to erythromycin resistance with genomic DNA from C. coli that harbored IVS and the A2075G transition in the 23S rRNA gene, associated with resistance to erythromycin in Campylobacter. Erythromycin-resistant transformants harbored both the A2075 transition and IVS. The findings suggest that the absence of IVS in C. coli from turkeys is characteristic of a unique clonal group of erythromycin-susceptible strains and that IVS can be acquired by these strains via natural transformation to erythromycin resistance.

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Quinolone and Macrolide Resistance in Campylobacter jejuni and C. coli: Resistance Mechanisms and Trends in Human Isolates

Cited by 612 publications

References 66 publications

Campylobacter

Campylobacter

High level of ciprofloxacin resistance and its molecular background among Campylobacter jejuni strains isolated in the United Arab Emirates

The Absence of Intervening Sequences in 23S rRNA Genes of Campylobacter coli Isolates from Turkeys Is a Unique Attribute of a Cluster of Related Strains Which Also Lack Resistance to Erythromycin

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