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In the United States, an estimated 0.8 million cases of campylobacteriosis occur annually, mostly involving\n                    <jats:named-content content-type=\"genus-species\">C. jejuni<\/jats:named-content>\n                    . Campylobacteriosis is generally self-limiting, but in severe cases, treatment with antibiotics may be mandated. The increasing incidence of fluoroquinolone resistance in\n                    <jats:named-content content-type=\"genus-species\">Campylobacter<\/jats:named-content>\n                    has rendered macrolides such as erythromycin and azithromycin the drugs of choice for human campylobacteriosis. The prevalence of macrolide resistance in\n                    <jats:named-content content-type=\"genus-species\">C. jejuni<\/jats:named-content>\n                    remains low, but macrolide resistance can be common in\n                    <jats:named-content content-type=\"genus-species\">C. coli<\/jats:named-content>\n                    . Substitutions in the 23S rRNA gene, specifically A2075G, and less frequently A2074C\/G, remain the most common mechanism for high-level resistance to macrolides. In\n                    <jats:named-content content-type=\"genus-species\">C. jejuni<\/jats:named-content>\n                    , resistance mediated by such substitutions is accompanied by a reduced ability to colonize chickens and other fitness costs, potentially contributing to the low incidence of macrolide resistance. Interestingly, similar fitness impacts have not been noted in\n                    <jats:named-content content-type=\"genus-species\">C. coli<\/jats:named-content>\n                    . Also noteworthy is a novel mechanism first reported in 2014 for a\n                    <jats:named-content content-type=\"genus-species\">C. coli<\/jats:named-content>\n                    isolate from China and mediated by\n                    <jats:italic>erm<\/jats:italic>\n                    (B) harbored on multidrug resistance genomic islands. The incidence of\n                    <jats:italic>erm<\/jats:italic>\n                    (B) appears to reflect clonal expansion of certain strains, and whole-genome sequencing has been critical to the elucidation of\n                    <jats:italic>erm<\/jats:italic>\n                    (B)-associated macrolide resistance in\n                    <jats:named-content content-type=\"genus-species\">Campylobacter<\/jats:named-content>\n                    spp. With the exception of one report from Spain,\n                    <jats:italic>erm<\/jats:italic>\n                    (B)-mediated macrolide resistance has been restricted to\n                    <jats:named-content content-type=\"genus-species\">Campylobacter<\/jats:named-content>\n                    spp., mostly\n                    <jats:named-content content-type=\"genus-species\">C. coli<\/jats:named-content>\n                    , of animal and human origin from China. If\n                    <jats:italic>erm<\/jats:italic>\n                    (B)-mediated macrolide resistance does not confer fitness costs in\n                    <jats:named-content content-type=\"genus-species\">C. jejuni<\/jats:named-content>\n                    , the range of this gene may expand in\n                    <jats:named-content content-type=\"genus-species\">C. jejuni<\/jats:named-content>\n                    , threatening to compromise treatment effectiveness for severe campylobacteriosis cases.\n                  <\/jats:p>","DOI":"10.1128\/aem.00416-17","type":"journal-article","created":{"date-parts":[[2017,4,14]],"date-time":"2017-04-14T20:25:26Z","timestamp":1492201526000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":155,"title":["The Current State of Macrolide Resistance in Campylobacter spp.: Trends and Impacts of Resistance Mechanisms"],"prefix":"10.1128","volume":"83","author":[{"given":"Hannah","family":"Bolinger","sequence":"first","affiliation":[{"name":"Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Kathariou","sequence":"additional","affiliation":[{"name":"Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","volume-title":"Antibiotic resistance threats in the United States, 2013","author":"Centers for Disease Control and Prevention","year":"2013","unstructured":"Centers for Disease Control and Prevention. 2013. 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