Evidence map›Paper›PMID 41545398›Full record

ArticleScientific reports2026

Widespread macrolide resistance among rapidly growing mycobacteria due to plasmids containing erm(55).

Christopher I Graham, Barbara A Brown-Elliott, Bibiana Gonzalez-Ramirez, Kavya Somayaji, Stephanie Melton, Michelle Wuzinski, Nancy L Wengenack, Richard J Wallace, David C Alexander

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In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Molecular Mechanisms Underlying Antimicrobial Resistance in Mycobacteria.International journal of molecular sciences · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Christopher I GrahamCadham Provincial Laboratory, Diagnostic Services, Shared Health, Winnipeg, MB, Canada.
Barbara A Brown-ElliottMycobacteria/Nocardia Laboratory, University of Texas Health Science Center at Tyler, University of Texas at Tyler School of Medicine, Tyler, TX, USA.
Bibiana Gonzalez-RamirezMycobacteria/Nocardia Laboratory, University of Texas Health Science Center at Tyler, University of Texas at Tyler School of Medicine, Tyler, TX, USA.
Kavya SomayajiMycobacteria/Nocardia Laboratory, University of Texas Health Science Center at Tyler, University of Texas at Tyler School of Medicine, Tyler, TX, USA.
Stephanie MeltonMycobacteria/Nocardia Laboratory, University of Texas Health Science Center at Tyler, University of Texas at Tyler School of Medicine, Tyler, TX, USA.
Michelle WuzinskiCadham Provincial Laboratory, Diagnostic Services, Shared Health, Winnipeg, MB, Canada.
Nancy L WengenackDivision of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA.
Richard J WallaceMycobacteria/Nocardia Laboratory, University of Texas Health Science Center at Tyler, University of Texas at Tyler School of Medicine, Tyler, TX, USA.
David C AlexanderCadham Provincial Laboratory, Diagnostic Services, Shared Health, Winnipeg, MB, Canada. David.Alexander@gov.mb.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Macrolides (clarithromycin and azithromycin) are a mainstay of therapy for infections caused by rapidly growing mycobacteria (RGM). Historically, macrolide resistance in RGM species is associated with mutations in the 23S rRNA gene and chromosomal erythromycin ribosome methylase (erm) genes. We recently described macrolide resistance in the RGM species, Mycobacterium chelonae, due to a novel, plasmid-encoded erm(55) gene. For this study, we expanded our search to pigmented RGM species. Clinical isolates from two U.S. reference laboratories were screened. Isolates were collected between 1997 and 2024 from diverse clinical sites and multiple geographic locales. Here, we describe the genetic diversity of 30 erm(55)-containing plasmids from six different RGM species. The plasmids share a common 126 kb backbone but, due to insertions and deletions, vary in size from 119 to 173 kb. Six plasmids carry heavy metal resistance operons in addition to erm(55). These results imply that erm(55)-containing plasmids are highly promiscuous, conjugative, and have been spreading unnoticed for decades. They are present in M. chelonae as well as pathogenic pigmented RGM species, including M. bacteremicum, M. grossiae, M. iranicum, M. neoaurum and M. obuense. Their spread to other RGM species seems inevitable and has serious implications for antimicrobial therapy.

Indexed as

Bacterial ProteinsDrug Resistance, BacterialMacrolidesMethyltransferasesMycobacteriumPlasmidsAnti-Bacterial AgentsHumansMicrobial Sensitivity TestsAnti-Bacterial AgentsBacterial ProteinsMacrolidesMethyltransferasesAntimicrobial resistanceMycobacteriaPlasmid

Identifiers

PMID41545398
PMCPMC12816644

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