title: Development of quinolone-resistant Campylobacter fetus bacteremia in human immunodeficiency virus-infected patients.
abstract: Campylobacter fetus subspecies fetus has been recognized as a cause of systemic illness in immunocompromised hosts, including relapsing bacteremia in human immunodeficiency virus (HIV)-infected patients. Acquired resistance to quinolone therapy, while reported for a variety of bacteria, including Campylobacter jejuni, has not been previously documented for C. fetus. Two cases of quinolone-resistant C. fetus bacteremia were detected in HIV-infected patients. Cloning and nucleotide sequencing of the C. fetus gyrA gene in the 2 resistant isolates demonstrated a G-to-T change that led to an Asp-to-Tyr amino acid substitution at a critical residue frequently associated with quinolone resistance. In addition, comparison of the pre- and posttreatment isolates from 1 patient documented outer membrane protein changes temporally linked with the development of resistance. Relapsing C. fetus infections in quinolone-treated HIV-infected patients may be associated with the acquisition of resistance to these agents, and this resistance may be multifactorial.
authors.affiliation: Department of Infectious Diseases, Wilford Hall Medical Center, Ft. Sam Houston, TX, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Meier
authors.forename: D P
authors.initials: DP
authors.lastname: Dooley
authors.forename: J H
authors.initials: JH
authors.lastname: Jorgensen
authors.forename: C C
authors.initials: CC
authors.lastname: Sanders
authors.forename: W M
authors.initials: WM
authors.lastname: Huang
authors.forename: J E
authors.initials: JE
authors.lastname: Patterson
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology*; D000328:Adult; D019943:Amino Acid Substitution; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis; D002169:Campylobacter Infections / Q000188:drug therapy* / Q000235:genetics; D002168:Campylobacter fetus / Q000737:chemistry / Q000187:drug effects* / Q000235:genetics; D003001:Cloning, Molecular; D027081:DNA Gyrase; D004250:DNA Topoisomerases, Type II / Q000235:genetics*; D004352:Drug Resistance, Microbial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012008:Recurrence; D017422:Sequence Analysis, DNA
chemical_list: D000890:Anti-Infective Agents; D001425:Bacterial Outer Membrane Proteins; D024841:Fluoroquinolones; D027081:DNA Gyrase; D004250:DNA Topoisomerases, Type II