{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:23:43Z","timestamp":1777922623379,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2011,8,1]],"date-time":"2011-08-01T00:00:00Z","timestamp":1312156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2011,8]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Streptococcus pyogenes<\/jats:italic>\n                    or group A\n                    <jats:italic toggle=\"yes\">Streptococcus<\/jats:italic>\n                    , a major human pathogen, remains susceptible to beta-lactams, but resistance to other antibiotics is becoming more common. The purpose of this study was to characterize both phenotypic and genotypic epidemiological markers of group A\n                    <jats:italic toggle=\"yes\">Streptococcus<\/jats:italic>\n                    and to identify the mechanisms of resistance to macrolides and tetracyclines. A total of 103 strains, isolated at Charles Nicolle University Hospital of Tunis, were investigated. The rate of resistance to erythromycin was low (5%), whereas a high rate of tetracycline resistance was found (70%). All the macrolide-resistant isolates expressed the constitutive macrolide, lincosamide, and streptograminB phenotype and harbored the\n                    <jats:italic toggle=\"yes\">erm<\/jats:italic>\n                    (B) gene. Resistance to tetracycline was mainly due to the\n                    <jats:italic toggle=\"yes\">tet<\/jats:italic>\n                    (M) gene, which is commonly associated with the conjugative transposon Tn916. No significant association was found between\n                    <jats:italic toggle=\"yes\">erm<\/jats:italic>\n                    (B) and\n                    <jats:italic toggle=\"yes\">tet<\/jats:italic>\n                    (M) genes. The tetracycline-resistant strains belonged to 28 distinct\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    types. Among them,\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    118 was the most prevalent type, followed by\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    42, std432,\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    76, and\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    18. However,\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    1,\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    4,\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    6,\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    28, and\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    3 were the most frequent types among tetracycline susceptible isolates. Only\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    118 and\n                    <jats:italic toggle=\"yes\">emm<\/jats:italic>\n                    42 types (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009\u2264\u20090.05) were significantly associated with resistance to tetracycline.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2010.0160","type":"journal-article","created":{"date-parts":[[2011,5,25]],"date-time":"2011-05-25T18:49:44Z","timestamp":1306349384000},"page":"377-382","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Molecular Mechanisms of Tetracycline and Macrolide Resistance and\n                    <i>emm<\/i>\n                    Characterization of\n                    <i>Streptococcus pyogenes<\/i>\n                    Isolates in Tunisia"],"prefix":"10.1177","volume":"17","author":[{"given":"Manel","family":"Hraoui","sequence":"first","affiliation":[{"name":"Laboratoire de Recherche \u201cR\u00e9sistance aux Antimicrobiens","place":["Tunisia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilhem Boutiba-Ben","family":"Boubaker","sequence":"additional","affiliation":[{"name":"Laboratoire de Recherche \u201cR\u00e9sistance aux Antimicrobiens","place":["Tunisia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Doloy","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sa\u00cfda Ben","family":"Redjeb","sequence":"additional","affiliation":[{"name":"Laboratoire de Recherche \u201cR\u00e9sistance aux Antimicrobiens","place":["Tunisia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Bouvet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1093\/jac\/dkg100","article-title":"Significant increase in the prevalence of erythromycin-resistant, clindamycin-and miocamycin-susceptible (M phenotype) Streptococcus pyogenes in Spain","volume":"51","author":"Al\u00f3s J.I.","year":"2003","unstructured":"Al\u00f3s J.I., , Aracil B., , Oteo J., , G.mez-Garc.s J.L. 2003. Significant increase in the prevalence of erythromycin-resistant, clindamycin-and miocamycin-susceptible (M phenotype) Streptococcus pyogenes in Spain. J. Antimicrob. Chemother., 51:333\u2013337.","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0602.000212"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"3559","DOI":"10.1128\/AAC.48.9.3559-3562.2004","article-title":"Emergence of macrolide-resistant Streptococcus pyogenes strains in French children","volume":"48","author":"Bingen E.","year":"2004","unstructured":"Bingen E., , Bidet P., , Mihaila-Amrouche L., , Doit C., , Forcet S., , Brahimi N., , Bouvet A., , Cohen R. 2004. Emergence of macrolide-resistant Streptococcus pyogenes strains in French children. Antimicrob. Agents Chemother., 48:3559\u20133562.","journal-title":"Antimicrob. 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