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We investigated the mechanism of resistance to penicillin in two penicillin-resistant clinical isolates of viridans streptococci that caused life-threatening infections in two patients not receiving chronic penicillin therapy. The first was a strain of Streptococcus intermedius that was isolated from the cerebrospinal fluid of a patient with post-neurosurgical meningitis. The second was a strain of Streptococcus mitis recovered from the bloodstream of a leukemic patient with neutropenia. Both patients failed to respond to penicillin. The mechanism of resistance in these strains was associated with diminished affinity for penicillin of their penicillin-binding proteins, as compared with those of penicillin-susceptible control strains. We conclude that penicillin-resistant viridans streptococci may cause serious infections even in patients not receiving chronic penicillin therapy, that this resistance is clinically significant and may result in failure of penicillin therapy, and that the mechanism of resistance in these strains is associated with diminished affinity of the penicillin-binding proteins for penicillin.
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
August 1990,
Proceedings of the National Academy of Sciences of the United States of America,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
June 2007,
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
February 1979,
The New England journal of medicine,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
April 2000,
Pediatrics international : official journal of the Japan Pediatric Society,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
January 1983,
The Journal of infectious diseases,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
May 1981,
Antimicrobial agents and chemotherapy,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
October 1989,
Journal of clinical pathology,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
May 1995,
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
June 1979,
The New England journal of medicine,
J P Quinn, and
C A DiVincenzo, and
D A Lucks, and
R L Luskin, and
K L Shatzer, and
S A Lerner
May 1979,
Clinical pediatrics,
