{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:55:24Z","timestamp":1791204924041,"version":"4.1.0"},"reference-count":17,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32GM144295"],"award-info":[{"award-number":["T32GM144295"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["BAA 75D301-19C-06841"],"award-info":[{"award-number":["BAA 75D301-19C-06841"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["BAA 75D301-22-R-72097"],"award-info":[{"award-number":["BAA 75D301-22-R-72097"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["S10 OD032243"],"award-info":[{"award-number":["S10 OD032243"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["mSphere"],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"ABSTRACT<\/jats:title>\n \n \n \n Treatment of severe invasive\n Streptococcus pyogenes<\/jats:italic>\n infections has historically relied on \u03b2-lactam antibiotics with adjunctive clindamycin. Rising rates of lincosamide resistance have led to adoption of linezolid as an alternative adjunctive therapy. This report describes a clinical\n S. pyogenes<\/jats:italic>\n isolate carrying a multi-drug resistance gene,\n cfr<\/jats:italic>\n (C), known to confer the phenicol, lincosamide, oxazolidinone, pleuromutilin, and streptogramin A (PhLOPS\n A<\/jats:sub>\n ) resistance phenotype in other bacterial species. Strain GAS-390756 is a pharyngeal isolate collected from a child with pharyngitis in the United States. Whole-genome sequence analysis demonstrated that the isolate belonged to\n emm<\/jats:italic>\n type 89 and carried an integrative and conjugative element with\n erm<\/jats:italic>\n (B) and\n cfr<\/jats:italic>\n (C) cargo genes (ICE\n Spy<\/jats:italic>\n 390756). Antimicrobial susceptibility testing demonstrated the isolate was resistant to erythromycin and clindamycin but susceptible to linezolid, consistent with the activity of\n erm<\/jats:italic>\n (B) but not\n cfr<\/jats:italic>\n (C). Comparative analysis of\n cfr<\/jats:italic>\n (C)\u2019s genomic context suggested that the promoter sequence may have been lost during ICE\n Spy<\/jats:italic>\n 390756\u2019s acquisition of the gene. While GAS-390756 remains susceptible to linezolid, the expansion of\n cfr<\/jats:italic>\n (C)\u2019s host range into\n S. pyogenes<\/jats:italic>\n and its presence on a novel mobile element are concerning. In light of known expression mechanisms for other silent antimicrobial resistance genes, this observation carries epidemiologic and public health importance.\n <\/jats:p>\n <\/jats:sec>\n \n IMPORTANCE<\/jats:title>\n \n Treatment of severe invasive\n Streptococcus pyogenes<\/jats:italic>\n infection has traditionally relied on the adjunctive use of clindamycin with \u03b2-lactam antibiotic therapy. However, rising rates of clindamycin non-susceptibility have led clinicians to adopt linezolid as an alternative therapy. We identified\n S. pyogenes<\/jats:italic>\n isolated from a child with pharyngitis that carried the\n cfr<\/jats:italic>\n (C) gene. This gene causes resistance to multiple antibiotics, including clindamycin and linezolid, in other bacterial species. At the time of this study, we found no other instances of the\n cfr<\/jats:italic>\n (C) gene carried by\n S. pyogenes<\/jats:italic>\n in either published reports or the public genome sequence database. While this isolate remained sensitive to linezolid, the expanded host range of\n cfr<\/jats:italic>\n (C) found in a novel potentially mobile genomic element may herald the eventual emergence of broader antibiotic resistance in\n S. pyogenes<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1128\/msphere.00277-26","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:03:36Z","timestamp":1787317416000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["A novel integrative and conjugative element in\n Streptococcus pyogenes<\/i>\n carries a\n cfr<\/i>\n -like gene associated with linezolid resistance in other species"],"prefix":"10.1128","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8525-7566","authenticated-orcid":true,"given":"Daniel B.","family":"Amusin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]},{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-6775","authenticated-orcid":true,"given":"Lacy M.","family":"Simons","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dulce S.","family":"Garcia","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4596-7939","authenticated-orcid":true,"given":"Alan R.","family":"Hauser","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]},{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2314-5213","authenticated-orcid":true,"given":"Emma","family":"Office","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00m6w7z96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0416-5171","authenticated-orcid":true,"given":"Preeti","family":"Jaggi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03czfpz43","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Williams","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03a6zw892","id-type":"ROR","asserted-by":"publisher"}],"name":"Stanley Manne Children\u2019s Research Institute, Ann & Robert H. 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