The transcriptomes of Salmonella enterica serovar Typhimurium SL1344 lacking a functional ramA or ramR or with plasmid-mediated high-level overexpression of ramA were compared to those of the wild-type parental strain. Inactivation of ramA led to increased expression of 14 SPI-1 genes and decreased expression of three SPI-2 genes, and it altered expression of ribosomal biosynthetic genes and several amino acid biosynthetic pathways. Furthermore, disruption of ramA led to decreased survival within RAW 264.7 mouse macrophages and attenuation within the BALB/c ByJ mouse model. Highly overexpressed ramA led to increased expression of genes encoding multidrug resistance (MDR) efflux pumps, including acrAB, acrEF, and tolC. Decreased expression of 34 Salmonella pathogenicity island (SPI) 1 and 2 genes, decreased SipC production, decreased adhesion to and survival within macrophages, and decreased colonization of Caenorhabditis elegans were also seen. Disruption of ramR led to the increased expression of ramA, acrAB, and tolC, but not to the same level as when ramA was overexpressed on a plasmid. Inactivation of ramR had a more limited effect on pathogenicity gene expression. In silico analysis of a suggested RamA-binding consensus sequence identified target genes, including ramR, acrA, tolC, sipABC, and ssrA. This study demonstrates that the regulation of a mechanism of MDR and expression of virulence genes show considerable overlap, and we postulate that such a mechanism is dependent on transcriptional activator concentration and promoter sensitivity. However, we have no evidence to support the hypothesis that increased MDR via RamA regulation of AcrAB-TolC gives rise to a hypervirulent strain.Multidrug efflux pumps, such as the resistance-nodulationdivision (RND) superfamily member AcrAB-TolC in the Enterobacteriaceae, export many substrates, including antibiotics (9,27,29,49,51,64). AcrAB-TolC and homologous efflux systems are important in the pathogenicity of Salmonella enterica serovar Typhimurium (10, 14) and other bacterial species (11,15,16). Recent work by our laboratory in S. Typhimurium has shown that following the disruption of acrA, acrB, or tolC, a phenotype of decreased pathogenicity was associated with global changes in expression of genes involved in virulence (such as those in SPI-1), chemotaxis, and motility (70).Regulation of RND efflux pumps has been widely studied in Escherichia coli, with the global AraC/XylS family regulators marA, soxS, and rob having been shown to activate expression of efflux pumps (5,8,46,52,71). Mechanistically, this is achieved via the binding, and subsequent activation, of discrete but degenerate nucleotide sequences within regulon genes, known as mar-, rob-, or soxboxes (30,35,42,43). E. coli marA is part of the marRAB operon, linked to another operon, marCD, of unknown function. Expression of both is controlled from the same operator site, marO (20). Regulation of E. coli marA is provided through the local repressor marR (62), which controls the transcription of marA b...