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JAC Advance Access published online on November 20, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl470
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Review

Antibiotic-resistant Campylobacter: could efflux pump inhibitors control infection?

Teresa Quinn 1, Jean-Michel Bolla 2, Jean-Marie Pagès 2, and Séamus Fanning 1 *

1 Centre for Food Safety, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
2 EA 2197, IFR 48, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin 13385, Marseille Cedex 05, France

* To whom correspondence should be addressed.
Séamus Fanning, E-mail: sfanning{at}ucd.ie


  Abstract

Campylobacter is the most common cause of bacterial gastroenteritis in the world. Poultry is the main reservoir of human infections. The widespread use of antibiotics in agriculture and veterinary medicine has resulted in the emergence of an increasing number of antibiotic-resistant Campylobacter strains that can be transmitted to humans through the food chain. Of particular concern to public health is the prevalence of resistance to macrolides and fluoroquinolones that are used in the treatment of life-threatening campylobacteriosis. The CmeABC efflux system has been shown to contribute to the intrinsic and acquired resistance to these antibiotics. In addition, by mediating resistance to bile, it is essential for colonization of the chicken gut in vivo. Inhibition of CmeABC may provide an effective means of reversing antibiotic resistance and decreasing the transmission of Campylobacter via the food chain. This would positively impact on public health by decreasing the morbidity, mortality and increased healthcare costs associated with the treatment of antibiotic-resistant Campylobacter.

Keywords: fluoroquinolones; macrolides; colonization; resistance to bile; campylobacteriosis.
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