Antibiotic Resistance in Chlamydiae

Abstract

There are few documented reports of antibiotic resistance in Chlamydia and no examples of natural and stable antibiotic resistance in strains collected from humans. While there are several reports of clinical isolates exhibiting resistance to antibiotics, these strains either lost their resistance phenotype in vitro, or lost viability altogether. Differences in procedures for chlamydial culture in the laboratory, low recovery rates of clinical isolates and the unknown significance of heterotypic resistance observed in culture may interfere with the recognition and interpretation of antibiotic resistance. Although antibiotic resistance has not emerged in chlamydiae pathogenic to humans, several lines of evidence suggest they are capable of expressing significant resistant phenotypes. The adept ability of chlamydiae to evolve to antibiotic resistance in vitro is demonstrated by contemporary examples of mutagenesis, recombination and genetic transformation. The isolation of tetracycline-resistant Chlamydia suis strains from pigs also emphasizes their adaptive ability to acquire antibiotic resistance genes when exposed to significant selective pressure.

Keywords:

• antibiotic resistance
• Chlamydia
• heterotypic resistance
• persistence
• phenotypic resistance
• sexually transmitted infection
• trachoma recombination
• transformation

Acknowledgements

Sara Weeks and Bob Suchland are gratefully acknowledged for their critical review of the manuscript. We wish to dedicate this work to our recently deceased colleague Walter E Stamm. Dr Stamm was a wonderful individual who contributed in so many ways to our personal and professional lives, and we miss him dearly.

Financial & competing interests disclosure

Daniel Rockey receives grant support from the NIH and the US Department of Defense (MT/DTRA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

Daniel Rockey receives grant support from the NIH and the US Department of Defense (MT/DTRA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.