title: Is the molecular basis of metronidazole resistance in microaerophilic organisms understood?
abstract: Metronidazole is an antibiotic that has been effective against many microaerophilic microorganisms with importance in medicine and animal husbandry. The development of increasing resistance against current treatments by many of these organisms has created an urgent need to establish the molecular bases of resistance, knowledge which will help to develop novel diagnostic methods and identify new therapeutic targets. Significant progress has been made in understanding resistance to this antibiotic in the human pathogens Helicobacter pylori and, to a lesser extent, Campylobacter spp. However, insufficient knowledge of the physiology and genetics of these and other related bacteria has led to investigations based on hypotheses that themselves must be established more thoroughly. This review presents the status of our current knowledge of metronidazole resistance and outlines reasons to explain some of the conflicting evidence and controversy in the interpretation of results in this area.
authors.affiliation: Dept of Biochemistry and Molecular Genetics, School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, Australia. G.Mendz@unsw.edu.au
authors.forename: George L
authors.initials: GL
authors.lastname: Mendz
authors.forename: Francis
authors.initials: F
authors.lastname: Mégraud
mesh_terms: D000332:Aerobiosis; D000595:Amino Acid Sequence; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002167:Campylobacter / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology*; D008969:Molecular Sequence Data; D009154:Mutation; D009601:Nitroreductases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; C029492:aromatic NADH-dependent nitroreductase; D009601:Nitroreductases; C413454:flavin nitroreductase