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Applied and Environmental Microbiology, April 2007, p. 2156-2164, Vol. 73, No. 7
0099-2240/07/$08.00+0 doi:10.1128/AEM.02346-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

North Carolina State University, Department of Food Science, Raleigh, North Carolina 27695,1 Produce Safety and Microbiology Research Unit, Agricultural Research Service, U.S. Department of Agriculture, Albany, California 94710,2 North Carolina State University, Department of Poultry Science, Raleigh, North Carolina 276953
Received 4 October 2006/ Accepted 27 January 2007
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As these organisms are transferred from animals to humans, the emergence of antimicrobial resistance, possibly due to the common use of antibiotics in animal husbandry (3, 9, 14), is a cause for concern. The efficiency of fluoroquinolones for the treatment of human campylobacteriosis has been compromised by the emergence of a relatively high incidence of resistance to these antibiotics (9, 21). Multidrug-resistant strains of Campylobacter are especially of concern in regard to the treatment of human illness. C. coli isolates from poultry and other animals have been found to be more prone than C. jejuni isolates to harbor resistance to multiple antibiotics, including macrolides and fluoroquinolones (1, 3-5, 7, 12, 16, 19). Further information about the ecology, population structure, and reservoirs of multidrug-resistant isolates of Campylobacter would be beneficial in developing strategies aimed at reducing the prevalence of such microbes.
In the course of our laboratory's investigation of Campylobacter colonization of commercial turkeys, we found that turkeys in eastern North Carolina were frequently colonized by C. coli (15, 22). In addition, we observed extensive colonization of successive turkey flocks by the same (or closely related) strains of multidrug-resistant C. coli, with the bacteria harboring resistance to tetracycline, ampicillin, streptomycin, kanamycin, erythromycin, and ciprofloxacin/nalidixic acid (15). However, the reservoir for such multidrug-resistant C. coli strains remains unidentified and the population structure of these organisms is poorly understood.
Recent advances in DNA sequence-based subtyping involving multilocus sequence typing (MLST) (8, 17) along with other subtyping tools such as fla typing and pulsed-field gel electrophoresis (PFGE) (6, 23) can facilitate studies of such issues. Recently, MLST data from 488 C. coli strains from diverse meat animals in the United States suggested the feasibility of using MLST for the detection of host-associated alleles. At each of the seven MLST loci, alleles were identified that were either specific to or associated with a particular food animal (e.g., aspA32 was found only [25/25] in swine isolates and gltA65 was found predominantly [14/15] in chicken isolates). In addition, sequence types (STs) were strongly associated with the host, with many of these host-associated STs corresponding to multiple host-associated alleles (17).
In this study, our objective was to characterize the population structure of multidrug-resistant C. coli strains which were isolated from turkeys and which harbored resistance to tetracycline, streptomycin, erythromycin, kanamycin, and ciprofloxacin/nalidixic acid. The study provided evidence for a largely clonal population structure for these organisms and suggested associations between genotypes, hosts, and antibiotic resistance profiles that may be of relevance for source-tracking purposes.
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TABLE 1. Turkey-derived C. coli strains characterized in this study
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Antibiotic susceptibility determinations.
Susceptibilities to tetracycline, erythromycin, and ciprofloxacin were determined as described previously (15) with the agar dilution method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. C. jejuni ATCC 33560 (purchased from the American Type Culture Collection) was used as the quality control strain. In addition, we determined susceptibilities to streptomycin, kanamycin, and nalidixic acid by the agar dilution method. Quality control ranges have not yet been established by the CLSI for these antibiotics, and resistance was determined as described previously (15) by the growth of the bacteria following incubation at 42°C for 48 h with the following antibiotic concentrations: streptomycin, 15 µg/ml; kanamycin, 25 µg/ml; and nalidixic acid, 20 µg/ml. No growth of C. jejuni ATCC 33560 with any of these antimicrobials at the indicated concentrations was observed.
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A small number of STs corresponding to the majority of the MDR isolates were identified.
A total of 14 different STs were identified among the 59 MDR C. coli strains (Table 1). However, three STs (ST-1101, ST-1126, and ST-889) accounted for the majority of the strains (29, 27, and 14%, respectively). ST-1149 was identified in four MDR strains, and two other STs (ST-1193 and ST-1154) were identified in three strains each. The remaining eight STs were identified in only one strain each.
Nine of the 14 STs identified among MDR C. coli strains were found on two major branches of the minimum spanning tree incorporating all available STs of the 108 turkey-derived C. coli strains. STs on one branch (group I; 19 strains, all MDR) included ST-1154 and ST-1126, and those on the other branch (group II; 42 strains, 33 MDR) included ST-1171, ST-1170, ST-1198, ST-889, ST-1149, ST-1160, and ST-1101 (Fig. 1). No MDR isolates were identified among the distinct cluster (cluster II) that had been identified earlier (17) and that consisted of putatively chimeric C. coli isolates, mostly from turkeys, harboring the C. jejuni aspA103 allele (Fig. 1).
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FIG. 1. Placement of MDR strains in the minimum spanning tree of STs identified among C. coli strains from turkeys. STs of the 108 strains were analyzed using BioNumerics as described in Materials and Methods. STs are indicated by circles with the sizes proportional to the numbers of strains. Thick, short lines represent single-locus variants, while thin, longer lines represent double-locus variants. Dashed lines represent three or more allele differences. STs corresponding to MDR strains are labeled, and the total number of strains with each ST is indicated in parentheses. Shading represents MDR strains. Branch I and branch II correspond to branches of the minimum spanning tree harboring group I and group II STs, respectively. "Cluster II" strains were designated as described previously (17).
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Most of the STs of the MDR strains were turkey specific, not having been encountered among C. coli isolates from other sources (17). The sole exception was ST-1170, which was identified in a single MDR C. coli strain and which had also been identified earlier in two chicken isolates (17). These two ST-1170 chicken isolates were not from our laboratory's strain collection, and their antibiotic resistance profiles are not known. Comparison of these STs with those detected in C. coli isolates from various meat animals (17) suggested that a significant fraction (31/59) of the MDR strains from turkeys were closely related (one- or two-allele differences) to C. coli strains from chickens, with the majority of the remaining MDR strains having STs closely related to those found among strains from swine (data not shown).
Distribution of the MDR C. coli strains.
The majority of the strains (101/108) characterized by MLST were obtained from turkeys grown under the control of two different companies, with 20 and 81 of the 108 strains being obtained from birds of companies A and B, respectively (Table 1). Samples from turkeys of both companies yielded ST-1101 and ST-1126 MDR strains; only ST-889 (eight strains) was limited to birds from one company (Table 1).
Precise determination of possible temporal trends in the prevalence of the major STs was hampered by the fact that the majority (67%) of the strains subtyped by MLST were obtained in 2004, with the remaining strains obtained in the previous three years (Table 1). Nonetheless, the major STs of MDR strains were identified both among strains from 2004 and among those obtained in the previous period. Furthermore, the major STs were detected in strains obtained from birds of different ages, without strong evidence for age-specific trends in prevalence. For instance, of the 23 strains of ST-1101, 13 (57%) were obtained from brooders (1 to 7 weeks of age) and 10 (44%) were obtained from grow-out birds (8 to 21 weeks); of the 16 ST-1126 strains, 9 (56%) and 7 (44%) were from brooders and from grow-out birds, respectively.
PFGE and fla typing revealed genomic diversification among MDR strains of the same STs.
Analysis of the MDR strains with PFGE and fla typing revealed that the observed major STs and ST clusters could be partitioned further by these subtyping schemes. In group I (n = 19), a large PFGE-based cluster contained strains with ST-1126 and ST-1154 (Fig. 2). All 19 strains in this group were of the MDR phenotype. Nine distinct PFGE profiles based on SmaI and KpnI digests were detected among the 16 strains with ST-1126 (Fig. 2). However, one PFGE pattern based on SmaI, designated type a, was encountered among several isolates obtained between 2001 and 2004, and several other ST-1126 strains harbored closely related profiles, with a similarity to the type a profile of greater than 82% (Fig. 2). Two strains (6076 and 8286) with ST-1126 were unusual in having PFGE profiles highly different (72% similarity) from those of other strains of group I, including other ST-1126 strains (Fig. 2).
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FIG. 2. PFGE profiles of group I strains. Nineteen MDR strains were characterized by PFGE using SmaI and KpnI, and cluster analysis of the patterns was performed by BioNumerics as described in Materials and Methods. The line labeled "a" indicates strains with the same SmaI PFGE pattern (type a). The bracket indicates strains with closely related PFGE profiles.
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FIG. 3. PFGE profiles of group II strains. Forty-two strains were characterized by PFGE using SmaI and KpnI, and cluster analysis of the patterns was performed by BioNumerics as described in Materials and Methods. Strains which were not resistant to all six antibiotics are indicated by asterisks. The line labeled "b" indicates strains with the same or similar PFGE profiles (type b). Brackets indicate strains with closely related PFGE profiles.
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Analysis of the fla profiles of the 68 strains identified 15 different fla types that varied in similarity from 55 to 91% (data not shown). Two fla types (types 20 and 21) were predominant, being detected in 10 and 40 strains, respectively (Table 1). Several different fla types were detected among strains of the major STs (six, seven, and two fla types among ST-1126, ST-1101, and ST-889 strains, respectively) (Table 1). Several strains that shared the same PFGE profiles also had the same fla types; for example, the seven strains with the type b PFGE profile all shared the type 21 fla profile. On the other hand, six different fla types were detected among 13 strains with PFGE pattern type a (Table 1).
A conserved SmaI PFGE pattern (type a) was disseminated among MDR strains of different STs.
PFGE characterization of MDR C. coli strains identified 13 strains of various STs as having a conserved SmaI pattern (type a) (Fig. 4). Of these 13 strains, 12 had identical or closely related patterns (one- to two-band differences) with KpnI but one strain, SC 280, differed by several (four to five) KpnI bands (Fig. 4). As mentioned earlier, six fla types, including the predominant types 20 and 21, were identified among these 13 strains (Table 2). In addition to ST-1126, found in six of these strains, three other STs were identified: all three isolates of ST-1154 (5991, SC 141, and SC 144) as well as the three isolates of ST-1193 (8030, 1383, and 1203) had this conserved PFGE pattern, along with one of the 17 isolates of ST-1101 (SC 280) (Table 2). With the exception of that of SC 280 (ST-1101), the STs of these strains were assembled into one group (group I) in the minimum spanning tree (Fig. 1).
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FIG. 4. PFGE profiles of 13 strains with various STs but a conserved PFGE profile (type a). Cluster analysis of the SmaI and KpnI patterns was performed by BioNumerics as described in Materials and Methods.
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TABLE 2. C. coli MDR strains with SmaI PFGE pattern type a
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FIG. 5. PFGE-based clustering of C. coli strains investigated in this study. All 68 strains were analyzed by PFGE with SmaI and KpnI, and cluster analysis of the patterns was performed by BioNumerics as described in Materials and Methods. Two strains (1004 A and SC 242) could not be restricted with KpnI. Strains which were not resistant to all six antibiotics are indicated by asterisks.
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Among poultry-derived Campylobacter strains, strains from turkeys seem especially prone to be resistant to erythromycin and certain other antibiotics. Turkey strains are more likely to harbor resistance to both erythromycin and ciprofloxacin than strains from broilers (16), and strains from turkey meat at retail sites are more likely to be resistant to multiple antibiotics, including erythromycin, than their counterparts from chicken (12). A recent study with commercial turkeys in North Carolina showed that the birds were colonized frequently with C. coli strains that harbored resistance to multiple antibiotics, with genetically similar strains colonizing successive flocks in one farm (15).
In this study, the MDR phenotype (defined here as resistance to tetracycline, streptomycin, erythromycin, kanamycin, and nalidixic acid/ciprofloxacin) was encountered exclusively among turkey-derived C. coli isolates. None of the C. coli isolates obtained from other animals (e.g., broilers, swine, and cattle) in the same geographical region and investigated by MLST harbored this phenotype, even though several different antibiotic resistance profiles were identified. In our continuing studies with C. coli from turkeys and swine, strains with the MDR phenotype have been derived invariably from turkeys (S. Wright, R. Siletzky, and S. Kathariou, unpublished results).
The identification of certain major STs and ST clusters among the MDR strains suggested that a relatively small number of clonal groups was responsible for the majority of these strains. All of the major STs were specific to turkeys and were in fact not encountered among C. coli strains from swine from the same geographic region. These findings suggest that the MDR phenotype has evolved primarily among certain clonal groups of C. coli that colonize turkeys. Two of these clonal groups (ST-1101, with 17 MDR strains, and ST-1126, with 16 strains) were encountered repeatedly among organisms from different integrators and farms at several different time points between 2001 and 2004. A third, smaller clonal group, ST-889, was encountered among eight strains, obtained from four farms of one integrator. These findings suggest that these clonal groups have become disseminated and established in the turkey industry. In a previous study, we demonstrated that successive turkey flocks on a specific farm were colonized with MDR C. coli strains that had the same PFGE type and that fluctuations in the fla types in successive flocks could be detected (15).
One can speculate that MDR strains of the major ST lineages may have enhanced abilities to colonize turkeys or to persist in yet unidentified reservoirs, from which they become introduced repeatedly into the flocks. Antibiotic treatment regimens or other production practices in the turkey industry may have originally provided selection pressure for the acquisition of the MDR phenotype and the establishment and dissemination of the bacteria harboring it. Further studies are needed to determine the extent to which the MDR phenotype may be associated with the colonization of the host (turkeys) and with other aspects of the physiology of the organisms.
Even though it is also possible that the MDR phenotype emerges de novo in different flocks and farms, in our opinion this scenario is less likely, at least for the major STs 1101, 1126, and 889, since we would then expect to encounter these STs randomly among isolates with various antibiotic susceptibility profiles. Instead, all 16 strains with ST-1126, 17 of the 23 ST-1101 strains, and all eight ST-889 strains were MDR, even though they were derived from various locations and isolated at different times. Such data suggest that these lineages acquired the MDR phenotype and became disseminated subsequently. Preliminary data from our laboratory suggest that this phenotype is remarkably stable, persisting following numerous passages of the organisms in the absence of selection for antibiotic resistance (C. B. D'lima, unpublished results). In field strains with STs found among MDR organisms, susceptibilities to some of the antibiotics were encountered only among ST-1101 and ST-1149 strains. In all cases, susceptible strains lacked resistance to just one or two of the antibiotics (with nalidixic acid and ciprofloxacin considered to represent one antibiotic class). It is possible that such organisms have not yet acquired the corresponding resistance attributes. Alternatively, these strains may have evolved from MDR organisms by loss of certain resistance attributes, possibly through transformation with DNA from other strains that lacked such resistance.
The observed variation in genetic fingerprints of strains within the major MDR STs also supports the notion of disseminated lineages, with subsequent genomic diversification that can become evident with additional subtyping tools, such as PFGE and fla typing. On certain occasions, strains of the same ST harbored markedly different PFGE profiles, suggesting extensive diversification, possibly arising through genomic rearrangements, insertion sequences, and the excision or integration of other mobile elements that may be harbored by these strains. Some of the differences in PFGE patterns may also be due to the presence of megaplasmids, such as the plasmid identified in C. coli RM2228 (10). The genomic content of the MDR strains has not been characterized yet, and the possibly unique genetic attributes of these lineages (e.g., ST-1101, ST-1126, and ST-889) remain unidentified. Our findings suggest the usefulness of accompanying MLST with PFGE to enhance the resolution potential of strain typing.
In conclusion, we have provided evidence for the existence of certain clonal groups of C. coli that are disseminated among C. coli strains from turkeys in North Carolina, having been detected in organisms isolated at different times from diverse farms and companies and from birds of different age groups. The presently observed correlation between STs and the MDR profiles of the organisms suggests that MLST-based typing holds potential for source-tracking applications specific to the animal source (turkeys) as well as the antimicrobial resistance profile (MDR status) of C. coli. Further studies are needed to identify the possible reservoirs for these clones, to characterize the ecology and adaptations of the organisms, and to determine whether these clonal groups of MDR C. coli are encountered in isolates from other major turkey-growing regions in the United States or other countries.
We thank Steven Clark and the turkey company veterinarians and farm personnel for facilitating the collection of samples from which the strains were obtained. We appreciate the encouragement and support of all members of our laboratory.
Published ahead of print on 9 February 2007. ![]()
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