Of 203 human clinical isolates of Campylobacter jejuni from Alberta, Canada (1999 to 2002), 101 isolates (50%) were resistant to at least 64 μg of tetracycline/ml, with four isolates exhibiting higher levels of tetracycline resistance (512 μg/ml). In total, the MICs for 37% of tetracycline-resistant isolates (256 to 512 μg/ml) were higher than those previously reported in C. jejuni (64 to 128 μg/ml). In the tetracycline-resistant clinical isolates, 67% contained plasmids and all contained the tet(O) gene. Four isolates resistant to high levels of tetracycline (MIC = 512 μg/ml) contained plasmids carrying the tet(O) gene, which could be transferred to other isolates of C. jejuni. The tetracycline MICs for transconjugants were comparable to those of the donors. Cloning of tet(O) from the four high-level tetracycline-resistant isolates conferred an MIC of 32 μg/ml for Escherichia coli DH5α. In contrast, transfer to a strain of C. jejuni by using mobilization conferred an MIC of 128 μg/ml. DNA sequence analysis determined that the tet(O) genes encoding lower MICs (64 to 128 μg/ml) were identical to one other, although the tet(O) genes encoding a 512-μg/ml MIC demonstrated several nucleotide substitutions. The quinolone resistance determining region of four ciprofloxacin-resistant isolates (2%) was analyzed, and resistance was associated with a chromosomal mutation in the gyrA gene resulting in a Thr-86-Ile substitution. In addition, six kanamycin-resistant isolates contained large plasmids that carry the aphA-3 marker coding for 3′-aminoglycoside phosphotransferase. Resistance to erythromycin was not detected in 203 isolates. In general, resistance to most antibiotics in C. jejuni remains low, except for resistance to tetracycline, which has increased from about 8 to 50% over the past 20 years
Reverse transcriptase polymerase chain reaction was used to determine the amount of overexpression of the ampC gene in 52 cefoxitin-resistant Escherichia coli clinical isolates that had previously characterized mutations in their ampC promoter/attenuator regions. The results showed that mutations that create a consensus -35 box (TTGACA) are the most important factor in strengthening the ampC promoter, followed by base pair insertions that increase the distance between the -35 and -10 boxes to 17 or 18 bp. Mutations in the -10 box are of lesser importance and those in the attenuator region appear to have little effect on ampC expression. Three strains overexpress ampC due to the effect of insertion elements located in the ampC promoter regions. Further, the data show that there is no correlation between ampC overexpression and the minimum inhibition concentration of cefoxitin in clinical isolates. Overall, the data indicate that a combination of ampC promoter mutations and other strain-specific factors combine to contribute to the magnitude of cefoxitin resistance in E. coli.
The transfer 2 region (Tra2) of the conjugative plasmid drR27 (derepressed R27) was analyzed by PSI-BLAST, insertional mutagenesis, genetic complementation, and an H-pilus assay. Tra2 contains 11 matingpair formation (Mpf) genes that are essential for conjugative transfer, 9 of which are essential for H-pilus production (trhA, -L, -E, -K, -B, -V, -C, -P, and -W). TrhK has similarity to secretin proteins, suggesting a mechanism by which DNA could traverse the outer membrane of donors. The remaining two Mpf genes, trhU and trhN, play an auxiliary role in H-pilus synthesis and are proposed to be involved in DNA transfer and mating-pair stabilization, respectively. Conjugative transfer abilities were restored for each mutant when complemented with the corresponding transfer gene. In addition to the essential Mpf genes, three genes, trhO, trhZ, and htdA, modulate R27 transfer frequency. Disruption of trhO and trhZ severely reduced the transfer frequencies of drR27, whereas disruption of htdA greatly increased the transfer frequency of wild-type R27 to drR27 levels. A comparison of the essential transfer genes encoded by the Tra2 and Tra1 (T.
The plasmid pVir may play a role in the virulence of
Campylobacter
jejuni
, a leading cause of bacterial gastroenteritis. The pVir
plasmid was identified in 17% of 104
C. jejuni
clinical
isolates studied and was significantly associated with the occurrence of blood
in patient stool, a marker of invasive infection. The pVir plasmid was not
associated with greater occurrence of diarrhea, fever, pain, vomiting, or need
for patient hospitalization. Isolates containing pVir were also associated with
the presence of a tetracycline-resistance plasmid, but pVir did not transfer
with tetracycline-resistance plasmids to recipient strains of
C.
jejuni
. The association of pVir and bloody stool suggests that pVir
may be clinically relevant in
C. jejuni
infections.
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