Acquisition of fluoroquinolone resistance in Campylobacter jejuni leads to an increase in biofilm formation and virulence

Campylobacter jejuni is the leading cause of bacterial gastroenteritis with over 550 million cases reported yearly. The World Health Organization has listed C. jejuni as one of 12 microorganisms on a global priority list for antibiotic resistance due to a rapid increase in the number of strains resistant to fluoroquinolone antibiotics. This fluoroquinolone resistance is conferred through a single point mutation in the QRDR region within the gyrA gene which is also involved in DNA supercoiling homeostasis. We recently revealed that changes in DNA topology play a major role in the regulation of virulence in C. jejuni with relaxation of DNA supercoiling associated with increased attachment to and invasion of human epithelial cells. The aim of this study was to investigate whether fluoroquinolone resistant strains of C. jejuni displayed altered supercoiling associated phenotypes. A panel of mutants were derived against nalidixic acid and ciprofloxacin and shown to have a greater ability to form viable biofilms under aerobic conditions and that this phenotype was associated with changes in DNA supercoiling levels. These mutants were also shown to have an increased ability to attach to and invade epithelial cells in vitro and conferred an increase in the killing efficiency of Galleria mellonella. We report for the first time that fluoroquinolone resistance in C. jejuni is associated with an increase in virulence and the ability to form viable biofilms in oxygen rich environments. These altered phenotypes may play a critical role in the continued increase in fluoroquinolone resistance observed for this important pathogen.