{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T03:05:21Z","timestamp":1787454321191,"version":"build-2736575974"},"reference-count":61,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T00:00:00Z","timestamp":1716681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"EDCTP","doi-asserted-by":"publisher","award":["RIA2018V-2304-PREPARE"],"award-info":[{"award-number":["RIA2018V-2304-PREPARE"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001713","name":"EDCTP","doi-asserted-by":"publisher","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"name":"INF-ACT","award":["RIA2018V-2304-PREPARE"],"award-info":[{"award-number":["RIA2018V-2304-PREPARE"]}]},{"name":"INF-ACT","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Streptococcus agalactiae (group B streptococci, GBS) is responsible for severe infections in both neonates and adults. Currently, empiric antimicrobial therapy for sepsis and meningitis is the combined use of penicillin and gentamicin due to the enhanced bactericidal activity. However, high-level gentamicin resistance (HLGR) abrogates the synergism. The rate of HLGR was investigated within a dataset of 433 GBS strains collected from cases of invasive disease in both adults and neonates as well as from pregnant carriers. GBS isolates (n = 20, 4.6%) presented with HLGR (gentamicin MIC breakpoint &gt;1024 mg\/L) that was differently diffused between strains from adults or neonates (5.2% vs. 2.8%). Notably, 70% of HLGR GBS strains (14 isolates) were serotype IV. Serotype IV HLGR-GBS isolates were susceptible to all antibiotics tested, exhibited the alpha-C\/HvgA\/PI-2b virulence string, and belonged to sequence type 1010 (clonal complex (CC) 452). The mobile element that harbored the HLGR aac(6\u2032)-aph(2)\u2033 gene is a novel integrative and conjugative element (ICE) about 45 kb long, derived from GBS 515 ICE tRNALys. The clonal expansion of this HLGR hypervirulent serotype IV GBS CC452 sublineage may pose a threat to the management of infections caused by this strain type.<\/jats:p>","DOI":"10.3390\/antibiotics13060491","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T10:12:27Z","timestamp":1716804747000},"page":"491","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Emergence of High-Level Gentamicin Resistance in Streptococcus agalactiae Hypervirulent Serotype IV ST1010 (CC452) Strains by Acquisition of a Novel Integrative and Conjugative Element"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4290-9039","authenticated-orcid":false,"given":"Roberta","family":"Creti","sequence":"first","affiliation":[{"name":"Dipartimento di Malattie Infettive, Reparto di Antibiotico-Resistenza e Patogeni Speciali, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Imperi","sequence":"additional","affiliation":[{"name":"Dipartimento di Malattie Infettive, Reparto di Antibiotico-Resistenza e Patogeni Speciali, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-1593","authenticated-orcid":false,"given":"Uzma Basit","family":"Khan","sequence":"additional","affiliation":[{"name":"Parasites and Microbes Programme, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3534-7499","authenticated-orcid":false,"given":"Alberto","family":"Berardi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Recchia","sequence":"additional","affiliation":[{"name":"Dipartimento di Malattie Infettive, Reparto di Antibiotico-Resistenza e Patogeni Speciali, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3567-9266","authenticated-orcid":false,"given":"Giovanna","family":"Alfarone","sequence":"additional","affiliation":[{"name":"Dipartimento di Malattie Infettive, Reparto di Antibiotico-Resistenza e Patogeni Speciali, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6010-3157","authenticated-orcid":false,"given":"Giovanni","family":"Gherardi","sequence":"additional","affiliation":[{"name":"Dipartimento di Malattie Infettive, Reparto di Antibiotico-Resistenza e Patogeni Speciali, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"},{"name":"Unit\u00e0 di Ricerca di Scienze Batteriologiche Applicate, Facolt\u00e0 Dipartimentale di Medicina e Chirurgia, Universit\u00e0 Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S160","DOI":"10.1093\/cid\/cix656","article-title":"Infant GBS Disease Investigator Group. 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