Development of macrolide resistance by ribosomal protein L4 mutation in Streptococcus pyogenes during miocamycin treatment of an eight-year-old Greek.

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Development of macrolide resistance by ribosomal protein L4 mutation in Streptococcus pyogenes during miocamycin treatment of an eight-year-old Greek child with tonsillopharyngitis B. Bozdogan, P.C. Appelbaum, L. Ednie, I.N. Grivea, G.A. Syrogiannopoulos Clinical Microbiology and Infection Volume 9, Issue 9, Pages 966-969 (September 2003) DOI: 10.1046/j.1469-0691.2003.00670.x Copyright © 2003 European Society of Clinical Infectious Diseases Terms and Conditions

Figure 1 Pulsed-field gel electrophoresis pattern after SmaI digestion of three S. pyogenes strains recovered from throat cultures of a child with tonsillopharyngitis before and after treatment with miocamycin. Lane M, S. aureus ATCC 8325 was used as the molecular size standard. Lane 1, macrolide susceptible S. pyogenes recovered before treatment. Lane 2 and Lane 3, macrolide resistant S. pyogenes with L4 mutation, recovered after 8 and 28 days after treatment with miocamycin, respectively. Clinical Microbiology and Infection 2003 9, 966-969DOI: (10.1046/j.1469-0691.2003.00670.x) Copyright © 2003 European Society of Clinical Infectious Diseases Terms and Conditions

Figure 2 Alignment of deduced amino acid sequences of highly conserved region of L4 protein of S. pyogenes strains recovered before treatment with miocamycin (first visit) and 8 days (second visit) and 28 days (third visit) after the treatment. Strains isolated after treatment present a two amino acid deletion, tryptophan (W) and arginine (R) at positions 65 and 66, respectively. Clinical Microbiology and Infection 2003 9, 966-969DOI: (10.1046/j.1469-0691.2003.00670.x) Copyright © 2003 European Society of Clinical Infectious Diseases Terms and Conditions