title: Streptococcus sanguinis isolate displaying a phenotype with cross-resistance to several rRNA-targeting agents.
abstract: This study describes a clinical case of a 71-year-old male with a history of ischemic cardiomyopathy after left ventricular assist device (LVAD) endocarditis caused by methicillin-resistant Staphylococcus epidermidis (MRSE) and a rare linezolid-resistant Streptococcus sanguinis strain (MIC, 32 μg/ml). The patient received courses of several antimicrobial agents, including linezolid for 79 days. The S. sanguinis strain had mutations in the 23S rRNA (T2211C, T2406C, G2576T, C2610T) and an amino acid substitution (N56D) in L22 and exhibited cross-resistance to ribosome-targeting agents.
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA. rodrigo-mendes@jmilabs.com
authors.forename: Rodrigo E
authors.initials: RE
authors.lastname: Mendes
authors.forename: Lalitagauri M
authors.initials: LM
authors.lastname: Deshpande
authors.forename: Jihye
authors.initials: J
authors.lastname: Kim
authors.forename: Debra S
authors.initials: DS
authors.lastname: Myers
authors.forename: James E
authors.initials: JE
authors.lastname: Ross
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000081:Acetamides / Q000494:pharmacology* / Q000627:therapeutic use; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D060085:Coinfection / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004697:Endocarditis, Bacterial / Q000382:microbiology*; D006801:Humans; D000069349:Linezolid; D008297:Male; D020125:Mutation, Missense; D023303:Oxazolidinones / Q000494:pharmacology* / Q000627:therapeutic use; D010641:Phenotype; D017354:Point Mutation; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D012269:Ribosomal Proteins / Q000235:genetics; D013203:Staphylococcal Infections / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000382:microbiology*; D013291:Streptococcus / Q000187:drug effects* / Q000302:isolation & purification*
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D012338:RNA, Ribosomal, 23S; D012269:Ribosomal Proteins; D000069349:Linezolid