title: Identification of mutations in 23S rRNA gene of clarithromycin-resistant Mycobacterium intracellulare.
abstract: Clarithromycin is a potent macrolide that has been used for treating infections with nontuberculous mycobacteria. Pairs of susceptible and resistant Mycobacterium intracellulare strains were obtained from patients with chronic pulmonary M. intracellulare infections undergoing monotherapy with clarithromycin. Nucleotide sequence comparisons of the peptidyltransferase region in 23S rRNAs from parental and resistant strains revealed that in three of six resistant strains, for which the MIC was > 32 micrograms/ml, a single base was mutated (Escherichia coli equivalent, A-2058-->G, C, or U). As the modification of adenine 2058 by dimethylation is a frequent cause of macrolide resistance in a variety of different bacteria, we suggest that mutation of A-2058 confers acquired resistance to clarithromycin in M. intracellulare.
authors.affiliation: Institut für Medizinische Mikrobiologie, Medizinische Hochschule Hannover, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Meier
authors.forename: P
authors.initials: P
authors.lastname: Kirschner
authors.forename: B
authors.initials: B
authors.lastname: Springer
authors.forename: V A
authors.initials: VA
authors.lastname: Steingrube
authors.forename: B A
authors.initials: BA
authors.lastname: Brown
authors.forename: R J
authors.initials: RJ
authors.lastname: Wallace
authors.forename: E C
authors.initials: EC
authors.lastname: Böttger
mesh_terms: D001483:Base Sequence; D017291:Clarithromycin / Q000494:pharmacology*; D004352:Drug Resistance, Microbial / Q000235:genetics; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D008969:Molecular Sequence Data; D009154:Mutation / Q000235:genetics*; D015269:Mycobacterium avium Complex / Q000187:drug effects* / Q000235:genetics*; D009690:Nucleic Acid Conformation; D012338:RNA, Ribosomal, 23S / Q000737:chemistry / Q000235:genetics*
chemical_list: D012338:RNA, Ribosomal, 23S; D017291:Clarithromycin