Erythromycin-resistant

Another group of antibiotics that can be inactivated by hydrolysis are 14- and 15- membered macrolides [2]. Esterases cleave the lactone ring. The plasmid encoded ere genes are found in members of the Enter-obacteriaceae and increase the intrinsic resistance. Furthermore, these esterases can also be found in some isolates of erythromycin resistant staphylococci. 

Noguchi N, A Emura, H Matsuyama, K O Hara, M Sasatsu, M Kono (1995) Nucleotide sequence and characterization of erythromycin resistance determinant that encodes macrolide 2 phosphotransferas I in Escherichia coli. Antimicrob Agents Chemother 39 2359-2363. 

Cash P et al. A proteomic analysis of erythromycin resistance in Streptococcus pneumoniae. Electrophoresis 1999 20 2259-2268. 

Dreier J, Amantea E, Kellenberger L, Page MGP. (2007) Activity of the novel macrolide BAL19403 against ribosomes from erythromycin-resistant Propionibacterium acnes. Antimicrob Agents Chemother 51 4361-4365. 

Erythromycin is effective in the treatment and prevention of S. pyogenes and other streptococcal infections, but not those caused by the more resistant fecal streptococci. Staphylococci are generally susceptible to erythromycin, so this antibiotic is a suitable alternative drug for the penicillin-hypersensitive individual. It is a second-line drug for the treatment of gonorrhea and syphilis. Although erythromycin is popular for the treatment of middle ear and sinus infections, including H. influenzae, possible erythromycin-resistant S. pneumoniae is a concern. 

Gabashvili IS, Gregory ST, Valle M, Grassucci R, Worbs M, Wahl MC, Dahlberg AE, Erank J (2001) The polypeptide tunnel system in the ribosome and its gating in erythromycin resistance mutants of L4 and L22. Mol Cell 8 181-188... 

Weishlum B. (1995). Erythromycin resistance by ribosome modification. Antibiotic Agents and Chemotherapy 39 577-585. 

Clarithromycin is derived from erythromycin by addition of a methyl group and has improved acid stability and oral absorption compared with erythromycin. Its mechanism of action is the same as that of erythromycin. Clarithromycin and erythromycin are virtually identical with respect to antibacterial activity except that clarithromycin is more active against Mycobacterium avium complex (see Chapter 47). Clarithromycin also has activity against M leprae and Toxoplasma gondii. Erythromycin-resistant streptococci and staphylococci are also resistant to clarithromycin. 

Telithromycin Oral unaffected by efflux-mediated resistance so is active versus many erythromycin-resistant strains of pneumococci rare cases of fulminant hepatic failure ... 

O Hara, K. Kanda,T. Kono, M. Structure of a phosphorylated derivative of oleandomycin, obtained by reaction of oleandomycin with an extract of an erythromycin-resistant strain of Escherichia coli. J. Antibiot., 41,823-827 (1988)... 

Noguchi, N. Katayama, J. Expression in Pseudomonas aeruginosa of an erythromycin-resistance determinant that encodes the mphA gene for macrolide 2 -phosphotransferase I from Escherichia coli. Biol. Pharm. Bull., 21, 191-193 (1998)... 

C Lai, B Weisblum. Altered methylation of ribosomal RNA in an erythromycin-resistant strain of Staphylococcus aureus. Proc Natl Acad Sci (USA) 68 856-860, 1971. 

H Westh, DM Hougaard, J Vuust, VT Rosdahl. Prevalence of erm gene classes in erythromycin-resistant Staphylococcus aureus strains isolated between 1959 and 1988. Antimicrob Agents Chemother 39 369-373, 1995. 

E.A., Chloramphenicol-erythromycin resistance mutations in a 23S rRNA gene of EscheriMa coli. J. Bacteriol. 1985, 162, 551-557. 

Erythromycin (a macrolide Group I inhibitor ineffective in the archaea) impairs the functioning of bacterial SOS subunits by interacting with the central loop of domain IV of the 23S rRNA (Fig. 6). In bacteria ( . coli), erythromycin resistance is conferred by an A to U base change, or by the dimethylation of the A residue [142]. In erythromycin-resistant yeast S. cerevisiae) mitochondria, the equivalent A residue is replaced by a G[141]. In accord with these observations, all of the archaeal 23 S rRNAs sequenced until now resemble the large subunit rRNA of eucarya and of the erythromycin-resistant yeast mitochondrial ribosomes in having a G instead of the critical A residue [150]. Since the remaining structure of the peptidyltransferase loop is conserved in all of the... 

Fig, 6. The central loop of E. coli 23S RNA involved in erythromycin sensitivity. The encircled A residue is methylated in erythromycin-resistant ribosomes and is substituted by a G in all of the... 

From 387 clinical strains of erythromycin-resistant strains of S. pyogenes isolated in Italian laboratories from 1995 to 1998, 31% were assigned to the inducible and 17% to the constitutive MLS resistance phenotype... 

Of 302 clinical isolates of S. pyogenes from Portugal, 108 were resistant to erythromycin, and 86 also had a constitutive resistance to clindamycin (MLSB phenotype) (59). Four isolates had a phenotype characterized by low-level erythromycin resistance and high-level chn-damycin resistance. In another European study of 286 S. pneumoniae strains, 7% were resistant to penicUhn, and 35% were also resistant to clindamycin (60). Of 3205 group A streptococcal strains from Canada, only 18 and 2 strains respectively showed inducible and constitutive resistance to clindamycin (61). Among 180 strains of the Streptococcus milleri group isolated in Spain, 17% were resistant to clindamycin (62). 

Giovanetti E, Montanari MP, Mingoia M, Varaldo PE. Phenotypes and genotypes of erythromycin-resistant Streptococcus pyogenes strains in Italy and heterogeneity of inducibly resistant strains. Antimicrob Agents Chemother 1999 43(8) 1935 0. 

Multiple-drag resistant strain. Methicillin/erythromycin resistant strain. ... 

Seppala, H. Klankka, T. Vuopio-Vakila, J. Muotiala, A. Helenius, H. Lager, K. Huovinen, P. The effect of changes in consumption macrolide antibiotics on erythromycin resistance in Findland. N. Engl. J. Med. 1997, 337, 441-446. 

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