Antimicrobial Resistance in Campylobacter

Jørgen Engberg; Peter Gerner-Smidt; Monika Keelan; Diane E. Taylor

doi:10.1128/9781555817534.ch16

Chapter 16 : Antimicrobial Resistance in Campylobacter

Authors: Jørgen Engberg¹, Peter Gerner-Smidt², Monika Keelan³, Diane E. Taylor⁴

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Affiliations: 1: Unit of Gastrointestinal Infections, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; 2: Unit of Gastrointestinal Infections, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; 3: Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, and Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta T6G 2G3, Canada; 4: Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta T6G 2H7, Canada

Content Type: Monograph

Publication Year: 2006

Category: Bacterial Pathogenesis

Book DOI: 10.1128/9781555817534

Chapter DOI: 10.1128/9781555817534.ch16

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Abstract:

This chapter provides a review of prevalence and trends of resistance in Campylobacter jejuni and Campylobacter coli isolated from humans in different parts of the world and a more thorough description of the mechanisms of resistance, origin, spread, and clinical consequences of resistance. Aminoglycosides exhibit rapid and significant bactericidal effects in vitro and should initially be included for the treatment of Campylobacter bacteremia in patients who appear very ill. The only mechanism of chloramphenicol resistance identified in Campylobacter occurs through modification of chloramphenicol by chloramphenicol acetyltransferase, which prevents its binding to the ribosome. The majority of contacts between Tet(O) and the ribosome are mediated by the rRNA, and one interaction with ribosomal protein S12. Most of the antimicrobials used in veterinary medicine are tetracyclines and macrolides, which result in high and continuous selective pressure for the animal-colonizing bacteria, ultimately resulting in the acquisition of antimicrobial resistance genes. Investigation into the mechanisms of action of antimicrobials, as well as the transfer of resistance determinants, is necessary to gain effective control of antimicrobial resistance. Epidemiological and microbiological studies show that poultry is the most important source for quinolone-susceptible and quinolone-resistant Campylobacter infections in humans. Trends over time for macrolide resistance show stable low rates in most countries, and macrolides should remain the drug class of choice for C. jejuni and C. coli enteritis.

Citation: Engberg J, Gerner-Smidt P, Keelan M, Taylor D. 2006. Antimicrobial Resistance in Campylobacter, p 269-292. In Aarestrup F (ed), Antimicrobial Resistance in Bacteria of Animal Origin. ASM Press, Washington, DC. doi: 10.1128/9781555817534.ch16

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Antimicrobial Resistance in Campylobacter

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Figure 1.

Trends for quinolone resistance rates (in percentages) among C. coli and C. jejuni combined from human sources around the world. The bars represent both nalidixic acid and fluoroquinolone resistance and are based on mean values of resistance from numerous reports. Updated and modified from reference 46 . Additional data are from references 7 , 9 , 10 , 19 , 29 , 30 , 45 , 47 , 49 – 51 , 107 , 128 , 139 , and 201 , and V. Prouzet-Mauléon (personal communication).

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Figure 1.

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Figure 2.

Quinolone resistance rates (in percentages) among C. jejuni (Denmark, The Netherlands, and Norway) and C. jejuni and C. coli combined (Finland, Sweden, the United Kingdom, and the United States) by history of travel. Data are from references 7 , 11 , 25 , 47 , 84 , 139 , and 143 .

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Figure 2.

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Figure 3.

(A) Elongation cycle of protein synthesis; (B) inhibition by tetracycline (Tc); (C) model for Tet(O) action. (A) In the absence of antibiotics, the aa-tRNA–EF-Tu–GTP ternary complex catalyzes the binding of aa-tRNA to the open A site on the pretranslocation-state (Pre) ribosome. (B) Tc initially binds to the posttranslation-state (Post) ribosome and induces a conformational change (or steric clash) that blocks the aa-tRNA–EF-Tu–GTP ternary complex from occupying the A site, effectively inhibiting further protein synthesis. (C) If Tet(O) is present, it recognizes the Tc-blocked ribosome by virtue of its open A site, prolonged pausing, and possibly by a drug-induced conformational change. The interaction of Tet(O) with the ribosome induces rearrangements in the A site and triggers the release of Tc from the primary binding site prior to GTP hydrolysis. Tet(O) then hydrolyzes the bound GTP and likely leaves the ribosome with the GTPase-associated region in a configuration compatible with EF-Tu binding, thereby allowing protein synthesis to continue. Adapted from references 36 and 37 .

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Figure 3.

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Tables

Antimicrobial Resistance in Campylobacter

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Table 1.

Erythromycin or azithromycin resistance rates among C. jejuni, C. coli, and C. jejuni and C. coli combined isolated from humans worldwide since 1997

Table 1.

Erythromycin or azithromycin resistance rates among C. jejuni, C. coli, and C. jejuni and C. coli combined isolated from humans worldwide since 1997

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Table 2.

Antibiotics and their resistance mechanisms in Campylobacterspp.

Table 2.

Antibiotics and their resistance mechanisms in Campylobacterspp.

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Table 3.

Antimicrobial agents transported by CmeABC in C. jejuni

Table 3.

Antimicrobial agents transported by CmeABC in C. jejuni

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Table 4.

Studies evaluating the duration of illness in patients infected with quinolone-resistant Campylobacter strains versus quinolone-susceptible Campylobacter strains

Table 4.

Studies evaluating the duration of illness in patients infected with quinolone-resistant Campylobacter strains versus quinolone-susceptible Campylobacter strains

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Table 5.

Studies evaluating risk factors for quinolone-resistant Campylobacter infections a

Table 5.

Studies evaluating risk factors for quinolone-resistant Campylobacter infections a