ArticleAntimicrobial agents and chemotherapy2013
Heteroresistance to fosfomycin is predominant in Streptococcus pneumoniae and depends on the murA1 gene.
Article in Antimicrobial agents and chemotherapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis.Frontiers in microbiology · 2026Pooled it
- Klebsiella pneumoniae peptide hijacks a Streptococcus pneumoniae permease to subvert pneumococcal growth and colonization.Communications biology · 2024Article
- Antibiotic Resistance to Molecules Commonly Prescribed for the Treatment of Antibiotic-Resistant Gram-Positive Pathogens: What Is Relevant for the Clinician?Pathogens (Basel, Switzerland) · 2024Review
- Inducible Mega-Mediated Macrolide Resistance Confers Heteroresistance in Streptococcus pneumoniae.Antimicrobial agents and chemotherapy · 2023Article
- Host Cell Oxidative Stress Promotes Intracellular Fluoroquinolone Persisters of Streptococcus pneumoniae.Microbiology spectrum · 2022Article
- Analysis of host-pathogen gene association networks reveals patient-specific response to streptococcal and polymicrobial necrotising soft tissue infections.BMC medicine · 2022Article
- Article
- Mechanisms and clinical relevance of bacterial heteroresistance.Nature reviews. Microbiology · 2019Review
- Pharmacodynamics Of Linezolid-Plus-Fosfomycin Against Vancomycin-Susceptible And -Resistant Enterococci In Vitro And In Vivo Of AInfection and drug resistance · 2019Article
- The Potential Role of Fosfomycin in Neonatal Sepsis Caused by Multidrug-Resistant Bacteria.Drugs · 2017Review
- Fosfomycin.Clinical microbiology reviews · 2016Review
- Antimicrobial heteroresistance: an emerging field in need of clarity.Clinical microbiology reviews · 2015Review
- A low-affinity penicillin-binding protein 2x variant is required for heteroresistance in Streptococcus pneumoniae.Antimicrobial agents and chemotherapy · 2014Article
- Article
- Simultaneous splicing of multiple DNA fragments in one PCR reaction.Biological procedures online · 2013Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fosfomycin targets the first step of peptidoglycan biosynthesis in Streptococcus pneumoniae catalyzed by UDP-N-acetylglucosamine enolpyruvyltransferase (MurA1). We investigated whether heteroresistance to fosfomycin occurs in S. pneumoniae. We found that of 11 strains tested, all but 1 (Hungary(19A)) displayed heteroresistance and that deletion of murA1 abolished heteroresistance. Hungary(19A) differs from the other strains by a single amino acid substitution in MurA1 (Ala(364)Thr). To test whether this substitution is responsible for the lack of heteroresistance, it was introduced into strain D39. The heteroresistance phenotype of strain D39 was not changed. Furthermore, no relevant structural differences between the MurA1 crystal structures of heteroresistant strain D39 and nonheteroresistant strain Hungary(19A) were found. Our results reveal that heteroresistance to fosfomycin is the predominant phenotype of S. pneumoniae and that MurA1 is required for heteroresistance to fosfomycin but is not the only factor involved. The findings provide a caveat for any future use of fosfomycin in the treatment of pneumococcal infections.
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