title: Quinupristin-dalfopristin resistance in Streptococcus pneumoniae: novel L22 ribosomal protein mutation in two clinical isolates from the SENTRY antimicrobial surveillance program.
abstract: Resistance to quinupristin-dalfopristin (Q/D) among gram-positive cocci has been very uncommon. Two clinical isolates among 8,837 (0.02%) Streptococcus pneumoniae isolates were discovered in 2001 to 2002 with Q/D MICs of 4 micro g/ml. Each had a 5-amino-acid tandem duplication (RTAHI) in the L22 ribosomal protein gene (rplV) preventing synergistic ribosomal binding of the streptogramin combination. Similar gene duplication has been reported in Q/D-resistant Staphylococcus aureus.
authors.affiliation: The JONES Group/JMI Laboratories, North Liberty, Iowa 52317, USA. ronald-jones@jmilabs.com
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrell
authors.forename: Ian
authors.initials: I
authors.lastname: Morrissey
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001483:Base Sequence; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006801:Humans; D008969:Molecular Sequence Data; D009154:Mutation / Q000235:genetics*; D011018:Pneumonia, Pneumococcal / Q000382:microbiology*; D011159:Population Surveillance; D016601:RNA-Binding Proteins / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012269:Ribosomal Proteins; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics*; D006113:United Kingdom; D014769:Virginiamycin / Q000031:analogs & derivatives* / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D016601:RNA-Binding Proteins; D012269:Ribosomal Proteins; D014769:Virginiamycin; C067169:RPL22 protein, human; C113825:quinupristin