{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:22:09Z","timestamp":1777922529728,"version":"3.51.4"},"reference-count":0,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2005,9,1]],"date-time":"2005-09-01T00:00:00Z","timestamp":1125532800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2005,9]]},"abstract":"<jats:p>\n                    In the United States, penicillin-resistant variants of the Tennessee (Tenn)\n                    <jats:sup>23F<\/jats:sup>\n                    -4 clone account for a substantial\nproportion of the very-high-level penicillin-resistant (MIC 8 \u00b5g\/ml) infections in the 7-valent pneumococcal\nprotein conjugate vaccine (PCV7) era. Serotype 19A strains account for an increasing proportion of\npenicillin-nonsusceptible\n                    <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                    infections. Sequential transformations of the Tenn\n                    <jats:sup>23F<\/jats:sup>\n                    -4\nclone (penicillin MIC 0.1 \u00b5g\/ml) were performed with four penicillin-nonsusceptible serotype 19A international\nclones (penicillin MIC): S. Africa\n                    <jats:sup>19A<\/jats:sup>\n                    -7 (0.5 \u00b5g\/ml), Hungary\n                    <jats:sup>19A<\/jats:sup>\n                    -6 (2 \u00b5g\/ml), Slovakia\n                    <jats:sup>19A<\/jats:sup>\n                    -11 (8 \u00b5g\/ml),\nand South Africa\n                    <jats:sup>19A<\/jats:sup>\n                    -13 (8 \u00b5g\/ml). Fifty-two transformants were characterized by MICs, serogroup-specific\nPCR,\n                    <jats:italic toggle=\"yes\">pbp<\/jats:italic>\n                    PCR restriction profile and sequence,\n                    <jats:italic toggle=\"yes\">pspA<\/jats:italic>\n                    PCR restriction profile, and\n                    <jats:italic toggle=\"yes\">erm\/mef<\/jats:italic>\n                    PCR. A subset\nwas analyzed with multilocus sequence typing (MLST) and pulsed-field gel electrophoresis. Serotype 23F\ntransformants with penicillin MIC \u2265 8 \u00b5g\/ml were detected through a single transformation with the Hungary\n                    <jats:sup>19A<\/jats:sup>\n                    -6 clone or serial transformations using two to three different clones. Forty-four percent (14\/32) of\nthe transformants incorporated \u22651 new MLST allele. Using encapsulated donors, very-high-level penicillinresistant\nvariants of the Tenn\n                    <jats:sup>23F<\/jats:sup>\n                    -4 clone were detected. In addition to detecting stepwise increases in penicillin\nMIC, a 12-fold increase in penicillin MIC was achieved through a single transformation. This large increase\nin MIC may explain why this clone is commonly associated with very-high-level resistance in natural\npopulations. Recombination within the MLST housekeeping genes was commonly detected in the transformants\nthat had acquired penicillin resistance.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2005.11.271","type":"journal-article","created":{"date-parts":[[2005,10,4]],"date-time":"2005-10-04T13:00:40Z","timestamp":1128430840000},"page":"271-278","source":"Crossref","is-referenced-by-count":1,"title":["Detection of Very High\u2013Level Penicillin-Resistant Variants ofthe Tennessee\n                    <sup>23F<\/sup>\n                    -4 Clone Via Single and SerialTransformations with Four Serotype 19A InternationalPneumococcal Clones"],"prefix":"10.1177","volume":"11","author":[{"given":"M. Catherine","family":"McEllistrem","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer M.","family":"Adams","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Visweswaran","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics and Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saleem A.","family":"Khan","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2005,9]]},"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2005.11.271","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2005.11.271","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:23:07Z","timestamp":1777666987000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2005.11.271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,9]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2005,9]]}},"alternative-id":["10.1089\/mdr.2005.11.271"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2005.11.271","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,9]]}}}