title: Differences in the DNA sequence of the translational attenuator of several constitutively expressed erm(A) genes from clinical isolates of Streptococcus agalactiae.
abstract: OBJECTIVE
  To study the regulatory region of a constitutively expressed erm(A) gene in Streptococcus agalactiae clinical isolates.
  
  
  METHODS
  Thirty clinical isolates of S. agalactiae which were cross-resistant to erythromycin and clindamycin and with a clindamycin MIC higher than that of erythromycin were studied by PCR, sequencing and molecular typing.
  
  
  RESULTS
  PCR analysis revealed that all the strains harboured the erm(A) gene, either alone (26 isolates) or in combination with erm(B) (four isolates). Sequencing of the region upstream of erm(A) showed that all isolates possessed two types of genetic alteration. Most of the strains showed point mutations in the second leader peptide (mainly A137C) and, in four isolates (two clones), an insertion fragment with high homology to IS1381 and transposase genes was detected. Epidemiological analysis of strains indicated several clonal origins of isolates.
  
  
  CONCLUSIONS
  The mutations described here are thought to result in increased or constitutive expression of the erm(A) gene.
authors.affiliation: Servicio de Microbiología, Hospital Clínico San Carlos, Plaza Cristo Rey s/n, Madrid, 28040, Spain. eculebras.hcsc@salud.madrid.org
authors.forename: Esther
authors.initials: E
authors.lastname: Culebras
authors.forename: Iciar
authors.initials: I
authors.lastname: Rodríguez-Avial
authors.forename: Carmen
authors.initials: C
authors.lastname: Betriu
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Picazo
mesh_terms: D020121:5' Untranslated Regions / Q000235:genetics*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D001483:Base Sequence; D002981:Clindamycin / Q000494:pharmacology; D004251:DNA Transposable Elements; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004917:Erythromycin / Q000494:pharmacology; D008780:Methyltransferases / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D017422:Sequence Analysis, DNA; D013030:Spain; D013290:Streptococcal Infections / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D020121:5' Untranslated Regions; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; D004269:DNA, Bacterial; D002981:Clindamycin; D004917:Erythromycin; D008780:Methyltransferases; C431709:ErmA protein, Bacteria