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JAC Advance Access published online on April 13, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm041
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Emergence of a Streptococcus pneumoniae isolate resistant to streptogramins by mutation in ribosomal protein L22 during pristinamycin therapy of pneumococcal pneumonia

Vincent Cattoir1,*, Lilia Merabet1, Patrick Legrand1, Claude-James Soussy1 and Roland Leclercq2

1 Laboratoire de Bactériologie-Virologie-Hygiène, CHU Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris XII, Créteil, France 2 Service de Microbiologie, EA 2128 Relations Hôte et Microorganismes des Épithéliums, CHU Côte de Nacre, Université de Caen, 14033 Caen Cedex, France

Received 5 December 2006; returned 5 January 2007; revised 17 January 2007; accepted 29 January 2007

* Corresponding author. Tel: +33-1-49-81-68-16; Fax: +33-1-49-81-28-39; E-mail: vincent.cattoir{at}hmn.aphp.fr

Objectives: The aim of this study was to characterize the mechanism of resistance to macrolides and streptogramins of a Streptococcus pneumoniae strain isolated from blood cultures in an 80-year-old patient suffering from severe pneumonia unsuccessfully treated with pristinamycin.

Methods: Resistance genes erm(B) and mef(A) were searched for by PCR. Portions of genes for domains V and II of the 23S rRNA (rrl) and genes for ribosomal proteins L4 (rplD) and L22 (rplV) were amplified by PCR from total genomic DNA and sequenced.

Results: Resistance genes erm(B) and mef(A) were not detected. Only mutation in the rplV gene encoding ribosomal protein L22 was detected. The strain contained a six amino acid insertion (107KRTAHI108) in the C-terminus of the ribosomal protein L22.

Conclusions: This is the first report of emergence of a pneumococcus resistant to streptogramins by mutation in ribosomal protein L22 during treatment with pristinamycin.

Key Words: macrolide resistance , pneumococcus , riboprotein , rplV


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