Cross-resistance to 14-, 15- and 16-membered ring macrolides in Salmonella and Campylobacter

Ruby Singh1, Sampa Mukherjee2, Lucas B Harrision2

  • 1Center for Veterinary Medicine, Office of New Animal Drug Evaluation, U.S. Food and Drug Administration, Rockville, MD, USA.

Abstract

Insights

Macrolide resistance genes in Salmonella are linked to specific ring structures, while a single mutation in Campylobacter significantly increases resistance to all macrolides. This impacts antimicrobial susceptibility testing and treatment strategies.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Antimicrobial Resistance

Background:

  • Macrolide antibiotics are crucial for treating bacterial infections.
  • Emergence of macrolide resistance in bacterial pathogens like Salmonella and Campylobacter poses a significant public health threat.
  • Understanding the genetic basis of macrolide resistance is essential for developing effective treatment strategies.

Purpose of the Study:

  • To investigate the contribution of specific resistance determinants to macrolide resistance phenotypes in Salmonella and Campylobacter.
  • To analyze the impact of different macrolide ring structures on resistance mechanisms.
  • To identify genetic factors associated with azithromycin resistance in these bacteria.

Main Methods:

  • Antimicrobial susceptibility testing (AST) was performed on 126 azithromycin-resistant and -susceptible Salmonella and Campylobacter isolates.
  • Whole-genome sequencing (WGS) was employed to identify resistance determinants and mutations.
  • Minimum Inhibitory Concentration (MIC) values were determined for various macrolides.

Main Results:

  • Seven functional macrolide resistance determinants and one point mutation (acrB_R717L) were identified in azithromycin-resistant Salmonella.
  • These determinants conferred increased resistance to 14-, 15-, and 16-membered ring macrolides, with MIC increases up to 256-fold.
  • In Campylobacter, azithromycin-resistant isolates exhibited significantly higher MICs (16- to 4096-fold) for various macrolides compared to susceptible isolates, primarily due to a 23S rRNA mutation.

Conclusions:

  • Macrolide resistance gene function in Salmonella is associated with specific macrolide ring structures.
  • A single 23S rRNA mutation in Campylobacter leads to broad-spectrum macrolide resistance.
  • These findings highlight distinct resistance mechanisms in Salmonella and Campylobacter, informing antimicrobial stewardship.