The CmeABC efflux pump plays an important role in the antimicrobial resistance of Campylobacter jejuni and Campylobacter coli. The aim of this investigation was to study the effect of putative efflux pump inhibitors, phenyl-arginine-b-naphthylamide (PAbN) and 1-(1-naphthylmethyl)-piperazine (NMP), as well as the effect of putative efflux pump inducers, sodium salicylate and sodium deoxycholate, on the MIC levels of erythromycin, ciprofloxacin, kanamycin, tetracycline and rifampicin for C. jejuni and C. coli. Our results indicated that susceptibility to erythromycin and rifampicin increased, respectively, 8-to 32-and 8-to 64-fold in the presence of PAbN and to a lesser extent in the presence of NMP. Salicylate produced a 2-to 4-fold increase in ciprofloxacin MIC values, whereas little effect was observed in the presence of deoxycholate.
INTRODUCTIONCampylobacteriosis is the leading cause of bacterial gastroenteritis in industrialized countries (Friedman et al., 2000). Although in most cases the illness is self-limiting, in severe cases and in immunocompromised patients, the use of antimicrobial agents is warranted. However, the rapid increase in resistant strains and the emergence of strains with multiple resistances are of growing concern (Ruiz et al., 2007).It has been established that efflux pumps, particularly the resistance-nodulation-cell division (RND) type CmeABC pump, have an important role in the antimicrobial resistance of Campylobacter jejuni (Lin et al., 2002). The same efflux pump has recently been characterized in Campylobacter coli (Corcoran et al., 2005). This pump is able to significantly decrease the susceptibility of Campylobacter to a number of antimicrobials (Lin et al., 2002).Efforts have been made to find substances capable of reversing the action of the efflux pumps and which therefore have the potential to prevent antimicrobial resistance in vivo. A broad-spectrum efflux pump inhibitor (EPI), phenyl-arginine-b-naphthylamide (PAbN), was first characterized in Pseudomonas aeruginosa (Lomovskaya et al., 2001) and has since been studied in several bacteria, including Campylobacter (Cagliero et al., 2005;Gibreel et al., 2007;Payot et al., 2004). Another putative EPI is 1-(1-naphthylmethyl)-piperazine (NMP), characterized in Escherichia coli (Bohnert & Kern, 2005). It is able to partially reverse multidrug resistance in some members of the Enterobacteriaceae and in Acinetobacter baumannii (Bohnert & Kern, 2005;Pannek et al., 2006; Schumacher et al., 2006) but its effects on Campylobacter have not been studied previously.In E. coli, salicylic acid binds to a repressor protein, MarR, which results in the overexpression of the global regulatory gene marA. This causes the down-regulation of the outermembrane protein OmpF and an increase in the synthesis of the RND multidrug efflux pump AcrAB-TolC, which leads to decreased antimicrobial accumulation (Price et al., 2000). Salicylate has also been reported to increase the effect of antimicrobial aminoglycosides in E. coli (Aumercier et al., 1990). ...