{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:29:15Z","timestamp":1777922955725,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"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":[[2019,7]]},"abstract":"<jats:p>\n                    A total of 161\n                    <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                    were collected between 2013 and 2015 in Tehran, Iran. The strains were tested for antimicrobial susceptibility and minimum inhibitory concentrations, serotyped, and genotyped by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Penicillin-binding proteins (PBPs) were also typed by restriction fragment length polymorphism (PBP-RFLP). Out of 161 strains, 32 isolates (20%) were highly resistant to penicillin. The most frequent serotypes among the penicillin-nonsusceptible\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    (PNSP) were 14 (24%), 23F (18%), and 19F (17%). RFLP of\n                    <jats:italic toggle=\"yes\">pbp2b<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">pbp2x<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">pbp1a<\/jats:italic>\n                    genes revealed 8, 6, and 7 different patterns, respectively. Analysis of 93 PNSP isolates displayed 80 PFGE types with 8 common types constituting 21 (23%) isolates. The remaining 72 isolates (77%) were single types. MLST indicated a high degree of genetic diversity among the 93 PNSP with 36 different sequence types. Six internationally known penicillin resistant clones were identified in our isolates among which Spain\n                    <jats:sup>23F<\/jats:sup>\n                    -1 (ST81), Spain\n                    <jats:sup>6B<\/jats:sup>\n                    -2 (ST90), and Spain\n                    <jats:sup>9V<\/jats:sup>\n                    -3 (ST156) were the predominant clones. The results indicated international identifiable clones of\n                    <jats:italic toggle=\"yes\">S. pneumoniae,<\/jats:italic>\n                    especially Spain\n                    <jats:sup>23F<\/jats:sup>\n                    -1 with high penicillin resistance could play a major role in spread of antimicrobial resistance in Iran. The extensive sequence variation in PBP2x, PBP2b, and PBP1a in resistant strains of clinical and commensal\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    was suggestive of a widespread homologous recombination within\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    populations.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0336","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T15:19:31Z","timestamp":1550675971000},"page":"865-873","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["High Rate of Serotype Switching and Genetic Variations Indicates Widespread Recombination Between Clinical and Commensal Penicillin-Nonsusceptible\n                    <i>Streptococcus pneumoniae<\/i>\n                    in Tehran"],"prefix":"10.1177","volume":"25","author":[{"given":"Malihe","family":"Talebi","sequence":"first","affiliation":[{"name":"Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javad","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vahid","family":"Lohrasbi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parviz","family":"Owlia","sequence":"additional","affiliation":[{"name":"Molecular Microbiology Research Center (MMRC), Shahed University, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Reza","family":"Pourshafie","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"010401","article-title":"Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries","volume":"3","author":"Rudan I.","year":"2013","unstructured":"Rudan I., , O'brien K.L., , Nair H., , Liu L., , Theodoratou E., , Qazi S., , Luk\u0161i\u0107 I., , Walker C.L.F., , Black R.E., , and Campbell H.. 2013. Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. J. Glob. Health, 3:010401.","journal-title":"J. Glob. Health"},{"key":"e_1_3_4_3_2","unstructured":"World Health Organization. Pneumonia. Available at https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/pneumonia (accessed February 2019)."},{"key":"e_1_3_4_4_2","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0140-6736(80)90072-0","article-title":"High prevalence of penicillin-insensitive pneumococci in Port Moresby, Papua New Guinea","volume":"316","author":"Gratten M.","year":"1980","unstructured":"Gratten M., , Naraqi S., , and Hansman D.. 1980. High prevalence of penicillin-insensitive pneumococci in Port Moresby, Papua New Guinea. Lancet, 316:192\u2013195.","journal-title":"Lancet"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/15.1.77"},{"key":"e_1_3_4_6_2","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1128\/AAC.17.3.364","article-title":"Multiple changes of penicillin-binding proteins in penicillin-resistant clinical isolates of Streptococcus pneumoniae","volume":"17","author":"Hakenbeck R.","year":"1980","unstructured":"Hakenbeck R., , Tarpay M., , and Tomasz A.. 1980. Multiple changes of penicillin-binding proteins in penicillin-resistant clinical isolates of Streptococcus pneumoniae. Antimicrob. Agents Chemother. 17:364\u2013371.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_7_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1574-6968.1995.tb07433.x","article-title":"Genetics of high level penicillin resistance in clinical isolates of Streptococcus pneumoniae","volume":"126","author":"Barcus V.A.","year":"1995","unstructured":"Barcus V.A., , Ghanekar K., , Yeo M., , Coffey T.J., , and Dowson C.G.. 1995. Genetics of high level penicillin resistance in clinical isolates of Streptococcus pneumoniae. FEMS Microbiol. Lett. 126:299\u2013303.","journal-title":"FEMS Microbiol. Lett"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2014.10.005"},{"key":"e_1_3_4_9_2","doi-asserted-by":"crossref","first-page":"e0167803","DOI":"10.1371\/journal.pone.0167803","article-title":"Determination of characteristics of erythromycin resistant Streptococcus pneumoniae with preferred PCV usage in Iran","volume":"11","author":"Talebi M.","year":"2016","unstructured":"Talebi M., , Azadegan A., , Sadeghi J., , Ahmadi A., , Ghanei M., , Katouli M., , Owlia P., , and Pourshafie M.R.. 2016. Determination of characteristics of erythromycin resistant Streptococcus pneumoniae with preferred PCV usage in Iran. PLoS One, 11:e0167803.","journal-title":"PLoS One"},{"key":"e_1_3_4_10_2","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1007\/s00284-014-0704-7","article-title":"Molecular analysis of pbp2b in Streptococcus pneumonia isolated from clinical and normal flora samples","volume":"70","author":"Sadeghi J.","year":"2015","unstructured":"Sadeghi J., , Ahamadi A., , Douraghi M., , Pourshafie M., , and Talebi M.. 2015. Molecular analysis of pbp2b in Streptococcus pneumonia isolated from clinical and normal flora samples. Curr. Microbiol. 70:206\u2013211.","journal-title":"Curr. Microbiol"},{"key":"e_1_3_4_11_2","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"CLSI","year":"2011","unstructured":"CLSI. 2011. Performance Standards for Antimicrobial Susceptibility Testing. Clinical and Laboratory Standards Institute, Wayne, PA."},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.8.2349-2357.2002"},{"key":"e_1_3_4_13_2","doi-asserted-by":"crossref","first-page":"4020","DOI":"10.1128\/AAC.48.10.4020-4022.2004","article-title":"Alterations of penicillin-binding proteins 1A, 2X, and 2B in Streptococcus pneumoniae isolates for which amoxicillin MICs are higher than penicillin MICs","volume":"48","author":"Kosowska K.","year":"2004","unstructured":"Kosowska K., , Jacobs M., , Bajaksouzian S., , Koeth L., , and Appelbaum P.. 2004. Alterations of penicillin-binding proteins 1A, 2X, and 2B in Streptococcus pneumoniae isolates for which amoxicillin MICs are higher than penicillin MICs. Antimicrob. Agents Chemother. 48:4020\u20134022.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_14_2","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1086\/314664","article-title":"Molecular analysis of the genetic variation among penicillin-susceptible and penicillin-resistant Streptococcus pneumoniae serotypes in Canada","volume":"179","author":"Louie M.","year":"1999","unstructured":"Louie M., , Louie L., , Papia G., , Talbot J., , Lovgren M., , and Simor A.. 1999. Molecular analysis of the genetic variation among penicillin-susceptible and penicillin-resistant Streptococcus pneumoniae serotypes in Canada. J. Infect. Dis. 179:892\u2013900.","journal-title":"J. Infect. Dis"},{"key":"e_1_3_4_15_2","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1097\/INF.0000000000000751","article-title":"Decreased carriage and genetic shifts in the Streptococcus pneumoniae population after changing the seven-valent to the thirteen-valent pneumococcal vaccine in Norway","volume":"34","author":"Steens A.","year":"2015","unstructured":"Steens A., , Caugant D.A., , Aaberge I.S., , and Vestrheim D.F.. 2015. Decreased carriage and genetic shifts in the Streptococcus pneumoniae population after changing the seven-valent to the thirteen-valent pneumococcal vaccine in Norway. Pediatr. Infect. Dis. J. 34:875\u2013883.","journal-title":"Pediatr. Infect. Dis. J"},{"key":"e_1_3_4_16_2","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.3201\/eid1907.121830","article-title":"Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999\u20132011","volume":"19","author":"Richter S.S.","year":"2013","unstructured":"Richter S.S., , Heilmann K.P., , Dohrn C.L., , Riahi F., , Diekema D.J., , and Doern G.V.. 2013. Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999\u20132011. Emerg. Infect. Dis. 19:1074.","journal-title":"Emerg. Infect. Dis"},{"key":"e_1_3_4_17_2","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1099\/jmm.0.035675-0","article-title":"Characterization of highly antimicrobial-resistant clinical pneumococcal isolates recovered in a Chinese hospital during 2009\u20132010","volume":"61","author":"Zhang B.","year":"2012","unstructured":"Zhang B., , Gertz Jr R.E., ., Liu Z., , Li Z., , Fu W., , and Beall B.. 2012. Characterization of highly antimicrobial-resistant clinical pneumococcal isolates recovered in a Chinese hospital during 2009\u20132010. J. Med. Microbiol. 61:42\u201348.","journal-title":"J. Med. Microbiol"},{"key":"e_1_3_4_18_2","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1155\/2014\/196748","article-title":"Clinical features and outcomes of serotype 19A invasive pneumococcal disease in Calgary, Alberta","volume":"25","author":"Ricketson L.J.","year":"2014","unstructured":"Ricketson L.J., , Vanderkooi O.G., , Wood M.L., , Leal J., , and Kellner J.D.. 2014. Clinical features and outcomes of serotype 19A invasive pneumococcal disease in Calgary, Alberta. Can. J. Infect. Dis. Med. Microbiol. 25:e71\u2013e75.","journal-title":"Can. J. Infect. Dis. Med. Microbiol"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1702"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines4010004"},{"key":"e_1_3_4_21_2","first-page":"2199","volume-title":"J. Antimicrob. Chemother","author":"Golden A.R.","year":"2015","unstructured":"Golden A.R., , Rosenthal M., , Fultz B., , Nichol K.A., , Adam H.J., , Gilmour M.W., , Baxter M.R., , Hoban D.J., , Karlowsky J.A., , and Zhanel G.G.. 2015. Characterization of MDR and XDR Streptococcus pneumoniae in Canada, 2007\u201313. J. Antimicrob. Chemother. 70:2199\u2013;2202."},{"key":"e_1_3_4_22_2","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1093\/jac\/dkr048","article-title":"Predominance of ST320 among Streptococcus pneumoniae serotype 19A isolates from 10 Asian countries","volume":"66","author":"Shin J.","year":"2011","unstructured":"Shin J., , Baek J.Y., , Kim S.H., , Song J.-H., , and Ko K.S.. 2011. Predominance of ST320 among Streptococcus pneumoniae serotype 19A isolates from 10 Asian countries. J. Antimicrob. Chemother. 66:1001\u20131004.","journal-title":"J. Antimicrob. Chemother"},{"key":"e_1_3_4_23_2","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1128\/AAC.01494-10","article-title":"Evolution of clonal and susceptibility profiles of serotype 19A Streptococcus pneumoniae among invasive isolates from children in Spain (1990\u20132008)","volume":"55","author":"Tarrag\u00f3 D.","year":"2011","unstructured":"Tarrag\u00f3 D., , Aguilar L., , Garc\u00eda R., , Gimenez M.-J., , Granizo J.-J., , and Fenoll A.. 2011. Evolution of clonal and susceptibility profiles of serotype 19A Streptococcus pneumoniae among invasive isolates from children in Spain (1990\u20132008). Antimicrob. Agents Chemother. 55:2297\u20132302.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_24_2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/infdis\/164.2.302","article-title":"Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae","volume":"164","author":"Munoz R.","year":"1991","unstructured":"Munoz R., , Coffey T.J., , Daniels M., , Dowson C.G., , Laible G., , Casal J., , Hakenbeck R., , Jacobs M., , Musser J.M., , and Spratt B.G.. 1991. Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae. J. Infect. Dis. 164:302\u2013306.","journal-title":"J. Infect. Dis"},{"key":"e_1_3_4_25_2","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1128\/JB.01343-08","article-title":"Role of conjugative elements in the evolution of the multidrug-resistant pandemic clone Streptococcus pneumoniae Spain23F ST81","volume":"191","author":"Croucher N.J.","year":"2009","unstructured":"Croucher N.J., , Walker D., , Romero P., , Lennard N., , Paterson G.K., , Bason N.C., , Mitchell A.M., , Quail M.A., , Andrew P.W., , and Parkhill J.. 2009. Role of conjugative elements in the evolution of the multidrug-resistant pandemic clone Streptococcus pneumoniae Spain23F ST81. J. Bacteriol. 191:1480\u20131489.","journal-title":"J. Bacteriol"},{"key":"e_1_3_4_26_2","doi-asserted-by":"crossref","first-page":"e168","DOI":"10.1371\/journal.ppat.0030168","article-title":"Vaccine escape recombinants emerge after pneumococcal vaccination in the United States","volume":"3","author":"Brueggemann A.B.","year":"2007","unstructured":"Brueggemann A.B., , Pai R., , Crook D.W., , and Beall B.. 2007. Vaccine escape recombinants emerge after pneumococcal vaccination in the United States. PLoS Pathog. 3:e168.","journal-title":"PLoS Pathog"},{"key":"e_1_3_4_27_2","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2217\/fmb.12.2","article-title":"Molecular mechanisms of \u03b2-lactam resistance in Streptococcus pneumoniae","volume":"7","author":"Hakenbeck R.","year":"2012","unstructured":"Hakenbeck R., , Br\u00fcckner R., , Denapaite D., , and Maurer P.. 2012. Molecular mechanisms of \u03b2-lactam resistance in Streptococcus pneumoniae. Future Microbiol. 7:395\u2013410.","journal-title":"Future Microbiol"},{"key":"e_1_3_4_28_2","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1128\/AAC.40.4.829","article-title":"Penicillin-binding proteins 2b and 2x of Streptococcus pneumoniae are primary resistance determinants for different classes of beta-lactam antibiotics","volume":"40","author":"Grebe T.","year":"1996","unstructured":"Grebe T., , and Hakenbeck R.. 1996. Penicillin-binding proteins 2b and 2x of Streptococcus pneumoniae are primary resistance determinants for different classes of beta-lactam antibiotics. Antimicrob. Agents Chemother. 40:829\u2013834.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_29_2","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1128\/AAC.42.6.1329","article-title":"Alterations in PBP 1A essential for high-level penicillin resistance in Streptococcus pneumoniae","volume":"42","author":"Smith A.M.","year":"1998","unstructured":"Smith A.M., , and Klugman K.P.. 1998. Alterations in PBP 1A essential for high-level penicillin resistance in Streptococcus pneumoniae. Antimicrob. Agents Chemother. 42:1329\u20131333.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M116.764696"},{"key":"e_1_3_4_31_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/jac\/dki401","article-title":"Molecular characteristics of pbp1a and pbp2b in clinical Streptococcus pneumoniae isolates in Quebec, Canada","volume":"57","author":"Granger D.","year":"2005","unstructured":"Granger D., , Boily-Larouche G., , Turgeon P., , Weiss K., , and Roger M.. 2005. Molecular characteristics of pbp1a and pbp2b in clinical Streptococcus pneumoniae isolates in Quebec, Canada. J. Antimicrob. Chemother. 57:61\u201370.","journal-title":"J. Antimicrob. Chemother"},{"key":"e_1_3_4_32_2","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1128\/AAC.46.5.1273-1280.2002","article-title":"Effects of amino acid alterations in penicillin-binding proteins (PBPs) 1a, 2b, and 2x on PBP affinities of penicillin, ampicillin, amoxicillin, cefditoren, cefuroxime, cefprozil, and cefaclor in 18 clinical isolates of penicillin-susceptible,-intermediate, and-resistant pneumococci","volume":"46","author":"Nagai K.","year":"2002","unstructured":"Nagai K., , Davies T.A., , Jacobs M.R., , and Appelbaum P.C.. 2002. Effects of amino acid alterations in penicillin-binding proteins (PBPs) 1a, 2b, and 2x on PBP affinities of penicillin, ampicillin, amoxicillin, cefditoren, cefuroxime, cefprozil, and cefaclor in 18 clinical isolates of penicillin-susceptible,-intermediate, and-resistant pneumococci. Antimicrob. Agents Chemother. 46:1273\u20131280.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_33_2","doi-asserted-by":"crossref","first-page":"13403","DOI":"10.1073\/pnas.95.23.13403","article-title":"Identification of a structural determinant for resistance to \u03b2-lactam antibiotics in gram-positive bacteria","volume":"95","author":"Mouz N.","year":"1998","unstructured":"Mouz N., , Gordon E., , Di Guilmi A.-M., , Petit I., , Petillot Y., , Dupont Y., , Hakenbeck R., , Vernet T., , and Dideberg O.. 1998. Identification of a structural determinant for resistance to \u03b2-lactam antibiotics in gram-positive bacteria. Proc. Natl. Acad. Sci. U.S.A. 95:13403\u201313406.","journal-title":"Proc. Natl. Acad. Sci. U.S.A"},{"key":"e_1_3_4_34_2","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1128\/AAC.43.5.1252","article-title":"Diversity of substitutions within or adjacent to conserved amino acid motifs of penicillin-binding protein 2X in cephalosporin-resistant Streptococcus pneumoniae isolates","volume":"43","author":"Asahi Y.","year":"1999","unstructured":"Asahi Y., , Takeuchi Y., , and Ubukata K.. 1999. Diversity of substitutions within or adjacent to conserved amino acid motifs of penicillin-binding protein 2X in cephalosporin-resistant Streptococcus pneumoniae isolates. Antimicrob. Agents Chemother. 43:1252\u20131255.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_35_2","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1128\/AAC.48.5.1848-1855.2004","article-title":"Biochemical characterization of Streptococcus pneumoniae penicillin-binding protein 2b and its implication in \u03b2-lactam resistance","volume":"48","author":"Pagliero E.","year":"2004","unstructured":"Pagliero E., , Chesnel L., , Hopkins J., , Croiz\u00e9 J., , Dideberg O., , Vernet T., , and Di Guilmi A.M.. 2004. Biochemical characterization of Streptococcus pneumoniae penicillin-binding protein 2b and its implication in \u03b2-lactam resistance. Antimicrob. Agents Chemother. 48:1848\u20131855.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_4_36_2","first-page":"1993","volume-title":"Mol. Microbiol","author":"Laible G.","year":"1991","unstructured":"Laible G., , Spratt B., , and Hakenbeck R.. 1991. Interspecies recombinational events during the evolution of altered PBP 2x genes in penicillin\u2010resistant clinical isolates of Streptococcus pneumoniae. Mol. Microbiol. 5:1993\u20132002."}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/mdr.2018.0336","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2018.0336","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2018.0336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:34:13Z","timestamp":1777667653000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2018.0336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1089\/mdr.2018.0336"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2018.0336","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}