Abstract

Tetracycline-resistant bacterial were first isolated in 1953 from Shigella dysenteriae, a bacterium which causes bacterial dysentery. Since then tetracycline-resistant bacteria have been found in increasing numbers of species and genera. This has resulted in reduced effectiveness of tetracycline therapy over time. Tetracycline resistance is normally due to the acquisition of new genes often associated with either a mobile plasmid or transposon. These tetracycline resistance determinants are distinguishable both genetically and biochemically. Resistance is primarily due to either energy-dependent efflux of tetracycline or protection of the ribosomes from the action of tetracycline. Gram-negative tetracycline efflux proteins are linkedto represso proteins which in the absence of tetracycline block transcription of the repressor and structural efflux genes. In contrast, expression of the Gram-positive tetracycline efflux genes and some the ribosomal protection genes appears to be regulated by attenuation of mRNA trancription. Specific tetracycline resistance genes have been identified in 32 Gram-negative and 22 Gram-positive genera. Tetracycline-resistant bacteria are found in pathogens, opportunistic and normal flora species. Tetracycline-resistant bacteria can be isolated from man, animals, food, and environment. The nonpathogens in each of these ecosystems may play an important role as reservoirs for the antibiotic resistance genes. It is clear that if we are to reverse the trend toward increasingly antibiotic-resistant pathogenic bacteria we will need to change how antibiotics are used in both human and animal health and food production.

References

[1]
Levy
S.B.
(
1992
)
The Antibiotic Paradox: How Miracle Drugs are Destroying the Miracle
 
Plenum Press
,
New York
.
[2]
Chopra
I.
Hawkey
P.M.
Hinton
M.
(
1992
)
Tetracyclines, molecular and clinical aspects
J. Antimicrob. Chemother.
 ,
29
,
245
277
.
[3]
Levy
S.B.
(
1988
)
Tetracycline resistance determinants are widespread
ASM News
 ,
54
,
418
421
.
[4]
Klein
N.C.
Cunha
B.A.
(
1995
)
Tetracyclines
Medical Clinics N. America
 ,
79
,
789
801
.
[5]
Freeman
C.D.
Nightingale
C.H.
Quintiliani
R.
(
1994
)
Minocycline: old and new therapeutic uses
Int. J. Antimicrob. Agents
 ,
4
,
325
335
.
[6]
Roberts
M.C.
(
1989
)
Gene ransfer in the urongenital and respiratory tract
In:
Gene Transfer in the Environment
 
Levy
S.
Miller
R.V.
, Eds) pp
347
375
McGraw Hill Publishing Co
,
New York
.
[7]
Col
N.F.
O’Connor
R.W.
(
1987
)
Estimating world-wide current antibiotic usage: Report of task force 1
Rev. Infect. Dis.
 ,
9
,
S232
243
.
[8]
Levy
S.B.
(
1992
)
Active efflux mechanisms for antimicrobial resistance
Antimicrob. Agents Chemother.
 ,
36
,
695
703
.
[9]
Chopra
I.
(
1994
)
Tetracycline analogs whose primary target is not the bacterial ribosome
Antimicrob. Agents Chermother.
 ,
38
,
637
640
.
[10]
Taylor
D.E.
Chau
A.
(
1996
)
Tetracycline resistance mediated by ribosomal protection
Antimicrob. Agents Chemother.
 ,
40
,
1
5
.
[11]
Buck
M.A.
Cooperman
B.C.
(
1990
)
Single protein omission reconstitution studies of tetracycline binding to the 30 S subunit of Escherichia coli ribosomes
Biochemistry
 ,
29
,
5374
5379
.
[12]
Oliva
B.
Gordon
G.
McNicholas
P.
Ellestad
G.
Chopra
I.
(
1992
)
Evidence that tetracycline analogs whose primary target is not the bacterial ribosome cause lysis of Escherichia coli
Antimicrob. Agents Chemother.
 ,
36
,
913
919
.
[13]
Goldstein
F.W.
Kitzis
M.D.
Acar
J.F.
(
1994
)
N,N-dimethylglycyl-amido derivative of minocycline and 6-demethyl-6-desoxytetracycline, two new glycylcylines highly effective against tetracycline-resistant Gram-positive cocci
Antimicrob. Agents Chemother.
 ,
38
,
2218
2220
.
[14]
Humbert
P.
Treffel
P.
Chapuis
J.-F.
Buchet
S.
Derancourt
C.
Agache
P.
(
1991
)
The tetracyclines in dermatology
J. Am. Acad. Dermat.
 ,
25
,
691
697
.
[15]
Yanagimura
M.
Koike
F.
Hara
K.
(
1989
)
Collagenase activity in gingival crevicular fluid and inhibition by tetracyclines
J. Dental Res.
 ,
68
,
1691
1693
.
[16]
Hatsu
M.
Sasaki
T.
Gomi
S.
Kodama
Y.
Sezaki
M.
Inouye
S.
Kondo
S.
(
1992
)
A new tetracycline with antitumor activity: II the structural elucidation of SF2575
J. Antibiot.
 ,
45
,
325
330
.
[17]
Falkow
S.
(
1975
)
Infectious Multiple Drug Resistance
 
Pion Limited
,
London
.
[18]
Akiba
T.
Koyama
K.
Ishiki
Y.
Kimura
S.
Fukushima
T.
(
1960
)
On the mechanism of the development of multiple-drug-resistant clones of Shigella
Japan J. Microbiol.
 ,
4
,
219
.
[19]
Watanabe
T.
(
1963
)
Infectious heredity of multiple drug resistance in bacteria
Bacteriol. Rev.
 ,
27
,
87
115
.
[20]
Lima
A.A.M.
Lima
N.L.
Pinho
M.C.
Barros
E.A.
Jr.
Teixeria
M.J.
Marins
M.C.V.
Guerrant
R.L.
(
1995
)
High frequency of strains multiply resistant to ampicillin, trimethoprim-sulfamethoxazole, streptomycin, chloramphenicol, and tetracycline isolated from patients with shigellosis in northeastern Brazil during the period 1988 to 1993
Antimicrob. Agents Chemother.
 ,
39
,
256
259
.
[21]
Roberts
M.C.
(
1994
)
Epidemiology of tetracycline resistance determinants
Trends Microbiol.
 ,
2
,
353
357
.
[22]
Gotohts
N.
Tsujimoto
H.
Poole
K.
Yamagishi
J.-I.
Nishino
T.
(
1995
)
The outer membrane protein OprM of Pseudomonas aeruginosa is encoded by oprK of the mexA-mexB-oprK multidrug resistance operon
Antimicrob. Agents Chemother.
 ,
39
,
2567
2569
.
[23]
George
A.M.
Hall
R.M.
Stokes
H.W.
(
1995
)
Mutidrug resistance in Klebsiella pneumoniae: a novel gene, ramA, confers a multidrug resistance phenotype in Escherichia coli
Microbiology
 ,
141
,
1909
1920
.
[24]
Charvalos
E.
Tselentis
Y.
Hamzehpour
M.M.
Kohler
T.
Pechere
J.-C.
(
1995
)
Evidence for an efflux pump in multidrug-resistant Campylobacter jejuni
Antimicrob. Agents Chemother.
 ,
39
,
2019
2022
.
[25]
Mendez
B.
Tachibana
C.
Levy
S.B.
(
1980
)
Heterogeneity of tetracycline resistance determinants
Plasmid
 ,
3
,
99
108
.
[26]
Levy
S.B.
McMurry
L.M.
Burdett
V.
Courvalin
P.
Hillen
W.
Roberts
M.C.
Taylor
D.E.
(
1989
)
Nomenclature for tetracycline resistance determinants
Antimicrob. Agents Chemother.
 ,
33
,
1373
1374
.
[27]
Charpentier
E.
Gerbaud
G.
Courvalin
P.
(
1993
)
Characterization of a new class of tetracycline-resistance gene tet(S) in Listeria monocytogenes BM4210
Gene
 ,
131
,
27
34
.
[28]
Jones
C.S.
Osborne
D.J.
Stanley
J.
(
1992
)
Enterobacterial tetracycline resistance in relation to plasmid incompatibility
Mol. Cell. Probes
 ,
6
,
313
317
.
[29]
Jones
C.S.
Osborne
D.J.
Stanley
J.
(
1992
)
Cloning of a probe for a previously undescribed enterobacterial tetracycline resistance gene
Lett. Appl. Microb.
 ,
15
,
106
108
.
[30]
Reynes
J.P.
Calmels
T.
Drocourt
D.
Tiragy
G.
(
1988
)
Cloning, expression in Escherichia coli and nucleotide sequence of a tetracycline-resistance gene from Streptomyces rimosus
J. Gen. Microbiol.
 ,
134
,
585
598
.
[31]
Dittrich
W.
Schrempf
H.
(
1992
)
The unstable tetracycline resistance gene of Streptomyces lividans 1326 encodes a putative protein with similarities to translational elongation factors and Tet (M) and Tet (O) proteins
Antimicrob. Agents Chemother.
 ,
36
,
1119
1124
.
[32]
Butler
M.J.
Friend
E.J.
Hunter
I.S.
Kaczmarek
F.S.
Sugden
D.A.
Warren
M.
(
1989
)
Molecular cloning of resistance genes and architecture of a linked gene cluster involved in biosynthesis of oxytetracycline by Streptomyces rimosus
Mol. Gen. Genet.
 ,
215
,
231
238
.
[33]
Doyle
D.
McDowall
K.J.
Bulter
M.J.
Hunter
I.S.
(
1991
)
Characterization of an oxytetracycline-resistance gene, otrA, of Streptomyces rimosus
Mol. Microbiol.
 ,
5
,
2923
2933
.
[34]
Sloan
J.
McMurry
L.M.
Lyras
D.
Levy
S.B.
Rood
J.I.
(
1994
)
The Clostridium perfringens Tet P determinant comprises two overlapping genes: tetA(P), which mediates active tetracycline efflux, and tetB(P), which is related to the ribosomal protection family of tetracycline-resistance determinants
Mol. Microbiol.
 ,
11
,
403
415
.
[35]
Benveniste
R.
Davies
J.
(
1973
)
Aminoglycoside antibiotic-inactivation enzymes in actinomycetes similar to those present in clinical isolates of antibiotic resistant bacteria
2nd Edn.
,
172
, In:
Proc. Natl. Acad. Sci. USA
 , pp
3628
3632
.
[36]
Guay
G.G.
Tuckman
M.
Rothstein
D.M.
(
1994
)
Mutations in the tetA(B) gene that cause a change in substrate specificity of the tetracycline efflux pump
Antimicrob. Agents Chemother.
 ,
38
,
857
860
.
[37]
Oliva
B.
Chopra
I.
(
1992
)
Tet determinants provide poor protection against some tetracyclines: further evidence for division of tetracyclines into two classes
Antimicrob. Agents Chemother.
 ,
36
,
876
878
.
[38]
Yamaguchi
A.
Ono
N.
Akasaka
T.
Noumi
T.
Sawai
T.
(
1990
)
Metal-tetracycline/H+ antiporter of Escherichia coli encoded by a transposon, Tn10
J. Biol. Chem.
 ,
265
,
15525
15530
.
[39]
Rubin
R.A.
Levy
S.B.
(
1991
)
Interdomain hybrid tet proteins confer tetracycline resistance only when they are derived from closely related members of the tet gene family
J. Bacteriol.
 ,
173
,
4503
4509
.
[40]
Hansen
L.M.
McMurry
L.M.
Levy
S.B.
Hirsch
D.C.
(
1993
)
A new tetracycline resistance determinant, Tet H, from Pasteurella multocida specifying active efflux of tetracycline
Antimicrob. Agents Chemother.
 ,
37
,
2699
2705
.
[41]
McNicholas
P.
McGlynn
M.
Guay
G.G.
Rothstein
D.M.
(
1995
)
Genetic analysis suggests functional interactions between the N- and C-terminal domains of the TetA(C) efflux pump encoded by pBR322
J. Bacteriol.
 ,
177
,
5355
5357
.
[42]
Sheridan
R.P.
Chopra
I.
(
1991
)
Origin of tetracycline efflux proteins: conclusions from nucleotide sequence analysis
Mol. Microbiol.
 ,
5
,
895
900
.
[43]
Gillespie
M.T.
May
J.W.
Skurray
R.
(
1986
)
Detection of an integrated tetracycline resistance plasmid in the chromosome of methicillin-resistant Staphylococcus aureus
J. Gen. Microbiol.
 ,
132
,
1723
1728
.
[44]
Sakaguchi
R.
Shishido
K.
(
1988
)
Molecular cloning of a tetracycline-resistance determinant from Bacillus subtilis chromosomal DNA and its expression in Escherichia coli and B. subtilis
Biochim. Biophys. Acta
 ,
949
,
9
57
.
[45]
Needham
C.
Rahman
M.
Dyke
K.G.H.
Noble
W.C.
(
1994
)
An investigation of plasmids from Staphylococcus aureus that mediate resistance to mupirocin and tetracycline
Microbiology
 ,
140
,
2577
2583
.
[46]
Projan
S.J.
Novick
R.
(
1988
)
Comparative analysis of five related staaphylococal plasmids
Plasmid
 ,
19
,
203
221
.
[47]
Khan
S.A.
Novick
R.P.
(
1983
)
Complete nucleotide sequence of pT181, a tetracycline resistance plasmid from Staphylococcus aureus
Plasmid
 ,
30
,
163
166
.
[48]
Higlander
S.K.
Novick
R.P.
(
1990
)
Mutational and physiological analyses of plasmid pT181 functions expressing incompatibility
Plasmid
 ,
23
,
1
15
.
[49]
Rouch
D.A.
Skurray
R.A.
(
1989
)
IS257 from Staphylococcus aureus: a member of an insertion sequence super-family prevalent among Gram-positive and Gram-negative bacteria
Gene
 ,
76
,
195
205
.
[50]
Gillespie
M.T.
Lyon
B.R.
Loo
L.S.L.
Mathhews
P.R.
Stewart
P.R.
Skurray
R.A.
(
1987
)
Homologous direct repeat sequences associated with mercury, methicillin, tetracycline and trimethoprim resistance in Staphylococcus aureus
FEMS Microbiol. Lett.
 ,
43
,
165
171
.
[51]
Schwarz
S.
Cardoso
M.
Wegener
H.C.
(
1992
)
Nucleotide sequence and phylogeny of tet(L) tetracycline resistance determinant encoded by plasmid pSTE1 from Staphylococcus hyicus
Antimicrob. Agents Chemother.
 ,
36
,
580
588
.
[52]
Roberts
M.C.
McFarland
L.V.
Mullany
P.
Mulligan
M.E.
(
1994
)
Characterization of the genetic basis of antibiotic resistance in Clostridium difficile
J. Antimicrob. Chemother.
 ,
33
,
419
429
.
[53]
Pang
Y.
Bosch
T.
Roberts
M.C.
(
1994
)
Single polymerase chain reaction for the detection of tetracycline resistant determinants Tet K and Tet L
Mol. Cell. Probes
 ,
8
,
417
422
.
[54]
Sanchez-Pescador
R.
Brown
J.T.
Roberts
M.
Urdea
M.S.
(
1988
)
Homology of the TetM with translational elongation factors: implications for potential modes of tetM conferred tetracycline resistance
Nucleic Acids Res.
 ,
16
,
1218
.
[55]
Roberts
M.C.
Pang
Y.
Riley
D.E.
Hillier
S.L.
Berger
R.
Krieger
J.N.
(
1993
)
Detection of Tet M and Tet O tetracycline resistance genes by polymerase chain reaction
Mol. Cell. Probes
 ,
7
,
387
393
.
[56]
Burdett
V.
(
1991
)
Purification and characterization of Tet(M), a protein that renders ribosomes resistant to tetracycline
J. Biol. Chem.
 ,
266
,
2872
2877
.
[57]
Manavathu
E.K.
Fernandez
C.L.
Cooperman
B.S.
Taylor
D.E.
(
1990
)
Molecular studies on the mechanism of tetracycline resistance mediated by Tet(O)
Antimicrob. Agents Chemother.
 ,
34
,
71
77
.
[58]
Burdett
V.
(
1993
)
tRNA modification activity is necessary for Tet(M)-mediated tetracycline resistance
J. Bacteriol.
 ,
175
,
7209
7215
.
[59]
Brown
J.T.
Roberts
M.C.
(
1987
)
Cloning and characterization of tetM from a Ureaplasma urealyticum strain
Antimicrob. Agents Chemother.
 ,
31
,
1852
1854
.
[60]
Morse
S.A.
Johnson
S.R.
Biddle
J.W.
Roberts
M.C.
(
1986
)
High-level tetracycline resistance in Neisseria gonorrhoeae due to the acquisition of the tetM determinant
Antimicrob. Agents Chemother.
 ,
30
,
664
670
.
[61]
Roberts
M.C.
(
1989
)
Plasmid-mediated Tet M in Haemophilus ducreyi
Antimicrob. Agents Chemother.
 ,
33
,
1611
1613
.
[62]
Knapp
J.S.
Johnson
S.R.
Zenilman
J.M.
Roberts
M.C.
Morse
S.A.
(
1988
)
High-level tetracycline resistance resulting from TetM in strains of Neisseria species, Kingella denitrificans, and Eikenella corrodens
Antimicrob. Agents Chemother.
 ,
32
,
765
767
.
[63]
Taylor
D.E.
Courvalin
P.
(
1988
)
Mechanisms of antibiotic resistance in Campylobacter species
Antimicrob. Agents Chemother.
 ,
32
,
1107
1112
.
[64]
Roberts
M.C.
Hillier
S.L.
(
1990
)
Genetic basis of tetracycline resistance in urogenital bacteria
Antimicrob. Agents Chemother.
 ,
34
,
261
264
.
[65]
Chaslus-Dancla
E.
Lesage-Descauses
M.-C.
Leroy-setrin
S.
Marel
J.-L.
Lafont
J.-P.
(
1995
)
Tetracycline resistance determinants, Tet B and Tet M detected in Pasteurella haemolytica and Pasteurella multocida from bovine herds
J. Antimicrob. Chemother.
 ,
36
,
815
819
.
[66]
Speer
B.S.
Bedzyk
L.
Salyers
A.A.
(
1991
)
Evidence that a novel tetracycline resistance gene found on two Bacteroides transposons encodes an NADP-requiring oxidoreductase
J. Bacteriol.
 ,
173
,
176
183
.
[67]
Hillen
W.
Berens
C.
(
1994
)
Mechanisms underlying expression of Tn10 encoded tetracycline resistance
Annu. Rev. Microbiol.
 ,
48
,
345
369
.
[68]
Kisker
C.
Hinrichs
W.
Tovar
K.
Hillen
W.
Saenger
W.
(
1995
)
The complex formed between Tet repressor and tetracycline-Mg2+ reveals mechanism of antibiotic resistance
J. Mol. Biol.
 ,
247
,
260
280
.
[69]
Levy
S.B.
Buu-Hoi
A.
Marshall
B.
(
1984
)
Transposon Tn10like tetracyclne resistance determinants in Haemophilus parainfluenzae
J. Bacteriol.
 ,
160
,
87
94
.
[70]
Heur
C.
Hickman
R.K.
Curiale
M.S.
Hillen
W.
Levy
S.B.
(
1987
)
Constitutive expression of tetracycline resistance mediated by a Tn10-like elements in Haemophilus parainfluenzae results from a mutation in the repressor gene
J. Bacteriol.
 ,
169
,
990
994
.
[71]
Tannock
G.W.
Luchansky
J.B.
Miller
L.
Connell
H.
Thode-Andersen
S.
Mercer
A.A.
Kaenhammer
T.R.
(
1994
)
Molecular characterization of a plasmid-borne (pGT633) erythromycin resistance determinant (ermGT) from Lactobacillus reuteri 100-63
Plasmid
 ,
31
,
60
71
.
[72]
Projan
S.J.
Monod
M.
Narayanan
C.S.
Dubnau
D.
(
1987
)
Replication properties of pIM13, a naturally occurring plasmid found in Bacillus subtilis, and of its close relative pE5, a plasmid native to Staphylococcus aureus
J. Bacteriol.
 ,
169
,
5131
5139
.
[73]
Wang
Y.
Taylor
D.E.
(
1991
)
A DNA sequence upstream of the tet(O) gene is required for full expression of tetracycline resistance
Antimicrob. Agents Chemother.
 ,
35
,
2020
2025
.
[74]
Nesin
M.
Svec
P.
Lupski
J.R.
Godson
G.N.
Kreiswirth
B.
Kornblum
J.
Projan
S.J.
(
1990
)
Cloning and nucleotide sequence of a chromosomally encoded tetraycline resistance determinant, tetA(M), from a pathogenic, methicillin-resistant strain of Staphylococcus aureus
Antimicrob. Agents Chemother.
 ,
34
,
2273
2276
.
[75]
Su
Y.A.
He
P.
Clewell
D.B.
(
1992
)
Characterization of the tet(M) determinant of Tn916: evidence for regulation by transcription attenuation
Antimicrob. Agents Chemother.
 ,
36
,
769
778
.
[76]
Flannagan
S.E.
Zitzow
L.A.
Su
Y.A.
Clewell
D.B.
(
1994
)
Nucleotide sequence of the 18-kb conjugative transposon Tn916 from Enterococcus faecalis
Plasmid
 ,
32
,
350
354
.
[77]
Li
L.-Y.
Shoemaker
N.B.
Salyers
A.A.
(
1995
)
Location and characteristics of the transfer region of Bacteriodes conjugative transposon and regulation of transfer genes
J. Bacteriol.
 ,
177
,
4992
4999
.
[78]
Salyers
A.A.
Shoemaker
N.B.
Li
L.-Y.
(
1995
)
In the Driver’s seat: the Bacteroides conjugative transposons and the elements they mobilize
J. Bacteriol.
 ,
177
,
5727
5731
.
[79]
Clewell
D.B.
Flannagan
S.E.
Jaworski
D.D.
(
1995
)
Unconstrained bacterial promiscuity: the Tn916-Tn1545 family of conjugative transposons
Trends Microbiol.
 ,
3
,
229
236
.
[80]
Naglich
J.G.
Andrews
R.E.
Jr.
(
1988
)
Tn916-dependent conjugal transfer of pC194 and pUB119 from Bacillus subtillis into Bacillus thuringiensis subsp. israelensis
Plasmid
 ,
20
,
113
126
.
[81]
Torres
O.R.
Korman
R.Z.
Zahler
S.A.
Dummy
G.M.
(
1991
)
The conjugative transposon Tn925: enhancement of conjugal transfer by tetracycline in Enterococcus faecalis and mobilization of chromosomal genes in Bacillus subtilis and E. faecalis
Mol. Gen. Genet.
 ,
225
,
395
400
.
[82]
Manganelli
R.
Romano
L.
Ricci
S.
Zazzi
M.
Pozzi
G.
(
1995
)
Dosage of Tn916 circular intermediates in Enterococcus faecalis
Plasmid
 ,
34
,
48
57
.
[83]
Scott
J.R.
(
1992
)
Sex and the single circle: Conjugative transposition
J. Bacteriol.
 ,
174
,
6005
6010
.
[84]
Kauc
L.
Goodgal
S.H.
(
1989
)
Introduction of transposon Tn916 DNA into Haemophilus influenzae and Haemophilus parainfluenzae
J. Bacteriol.
 ,
171
,
6625
6628
.
[85]
Rice
L.B.
Marshall
S.H.
Carias
L.L.
(
1992
)
Tn5381, a conjugative transposon identifiable as a circular form in Enterococcus faecalis
J. Bacteriol.
 ,
174
,
7315
7380
.
[86]
Le Bouguenec
C.
de Cespedes
G.
Horaud
T.
(
1990
)
Presence of chromosomal elements resembling the composite structure Tn3701 in streptococci
J. Bacteriol.
 ,
172
,
727
734
.
[87]
Facinelli
B.
Roberts
M.C.
Giovanetti
E.
Casolari
C.
Fabio
U.
Varaldo
P.E.
(
1993
)
Genetic basis of tetracycline resistance in food borne isolates of Listeria innocua
Appl. Environm. Microbiol.
 ,
59
,
614
616
.
[88]
Marshall
B.
Roberts
M.
Smith
A.
Levy
S.B.
(
1984
)
Homogeneity of tetracycline-resistance determinants in Haemophilus species
J. Infect. Dis.
 ,
149
,
1028
1029
.
[89]
Roberts
M.C.
Pang
Y.
Spencer
R.C.
Winstanley
T.G.
Brown
B.A.
Wallace
R.J.
Jr.
(
1991
)
Tetracycline resistance in Moraxella (Branhamella) catarrhalis-demonstration of two clonal outbreaks using a pulsed-field gel electrophoresis
Antimicrob. Agents Chemother.
 ,
35
,
2453
2455
.
[90]
Sorum
H.
Roberts
M.C.
Crosa
J.H.
(
1992
)
Identification and cloning of a tetracycline resistance gene from the fish pathogen Vibrio salmonicida
Antimicrob. Agents Chemother.
 ,
36
,
611
615
.
[91]
DePaola
A.
Roberts
M.C.
(
1995
)
Class D and E tetracycline resistance determinants in gram-negative catfish pond bacteria
Mol. Cell. Probes
 ,
9
,
311
313
.
[92]
Andersen
S.R.
Sandaa
R.-A.
(
1994
)
Distribution of tetracycline resistance determinants among gram-negative bacteria isolated from polluted and unpolluted marine sediments
Appl. Environ. Microbiol.
 ,
60
,
908
912
.
[93]
Lee
C.
Langlois
B.E.
Dawson
K.L.
(
1993
)
Detection of tetracycline resistance determinants in pig isolates from three herds with different histories of antimicrobial agent exposure
Appl. Environ. Microbiol.
 ,
59
,
1467
1472
.
[94]
Roberts
M.C.
Moncla
B.J.
Hillier
S.L.
(
1991
)
Characterization of unusual tetracycline resistant gram-positive bacteria
Antimicrob. Agents Chemother.
 ,
35
,
2655
2657
.
[95]
de Barbeyrac
B.
Dutilh
B.
Quentin
C.
Renaudin
H.
Bebear
C.
(
1991
)
Susceptibility of Bacteroides ureolyticus to antimicrobial agents and identification of a tetracycline resistance determinant related to tetM
J. Antimicrob. Chemother.
 ,
27
,
721
731
.
[96]
Roberts
M.C.
Smith
A.L.
(
1980
)
Molecular characterization of ‘plasmid-free’ antibiotic resistant Haemophilus influenzae
J. Bacteriol.
 ,
144
,
476
479
.
[97]
Roe
D.E.
Roberts
M.C.
Braham
P.
Weinberg
A.
(
1995
)
Characterization of tetracycline resistance in Actinobacillus actinomycetemcomitans
Oral Microbiol. Immun.
 ,
10
,
227
232
.
[98]
Roberts
M.C.
(
1990
)
Characterization of the Tet M determinant in urogenital and respiratory bacteria
Antimicrobl. Agents Chemother.
 ,
34
,
476
478
.
[99]
Xia
M.
Pang
Y.
Roberts
M.C.
(
1995
)
Detection of two groups of 25.2 Mda Tet M plasmids by polymerase chain reaction of the downstream region
Mol. Cell. Probes
 ,
9
,
327
332
.
[100]
Roberts
M.C.
Knapp
J.S.
(
1989
)
Transfer frequency of various 25.2 Mdal TetM-containing plasmids in Neisseria gonorrhoeae
Sex. Trans. Dis.
 ,
16
,
91
94
.
[101]
Olsvik
B.
Olsen
I.
Tenover
F.C.
(
1994
)
Tet tet(Q) gene in bacteria isolated from patients with refractory periodontal disease
Oral. Microbiol. Immunol.
 ,
9
,
251
255
.
[102]
Brown
M.B.
Roberts
M.C.
(
1991
)
Tetracycline resistance determinants in streptococcal species isolated from the bovine mammary gland
Vet. Microb.
 ,
29
,
173
180
.
[103]
Zhao
J.
Aoki
T.
(
1992
)
Nucleotide sequence analysis of the Class G tetracycline resistance determinant from Vibrio anguillarum
Microbiol. Immunol.
 ,
36
,
1051
1060
.
[104]
Aoki
T.
Satoh
T.
Kitao
T.
(
1987
)
New tetracycline resistance determinant on R-plasmids from Vibrio anguillarum
Antimicrob. Agents Chemother.
 ,
31
,
1446
1449
.
[105]
Marshall
B.
Tachibana
C.
Levy
S.B.
(
1983
)
Frequency of tetracycline resistance determinant classes among lactose-fermenting coliforms
Antimicrob. Agents Chemother.
 ,
24
,
835
840
.
[106]
DePaola
A.
Flynn
P.A.
McPherarson
R.M.
Levy
S.B.
(
1988
)
Phenotypic and genotypic characterization of tetracycline- and oxytetracycline-resistant Aeromonas hydrophila from cultured channel catfish (Ictalurus punctatus) and their environments
Appl. Environ. Microb.
 ,
54
,
1861
1863
.
[107]
DePaola
A.
Hill
W.E.
Harrell
F.M.
(
1993
)
Oligonucleotide probe determination of tetracycline-resistant bacteria isolated from catfish ponds
Mol. Cell. Probes
 ,
7
,
345
348
.
[108]
Martinez-Salazar
J.M.
Alvarez
G.
Gomez-Eichelmann
M.C.
(
1986
)
Frequency of four classes of tetracycline resistance determinants in Salmonella and Shigella spp. clinical isolates
Antimicrob. Agents Chemother.
 ,
30
,
630
631
.
[109]
Kariuki
S.
Mirza
N.B.
Wasteson
Y.
Senerwa
D.
Gathuma
J.M.
Olsvik
O.
(
1992
)
Tetracycline resistance genes in Kenyan hospital isolates of Salmonella typhimurium
APMIS
 ,
100
,
629
634
.
[110]
van Klingeren
B.
van Embden
J.D.A.
Dessens-Kroon
M.
(
1977
)
Plasmid-mediated chloramphenicol resistance in Haemophilus influenzae
Antimicrob. Agents Chemother.
 ,
11
,
383
387
.
[111]
Acar
J.F.
Bouanchaud
D.H.
Chabbert
Y.A.
(
1977
)
Evolutionary aspects of plasmid mediated resistance in a hospital environment
2nd Edn.
In:
Topics in Infectious Diseases; R-Factors: Their Properties and Possible Control
 
Drews
J.
Hogenauer
G.
, Eds) Vol.
2
, pp
5
23
Springer-Verlag
,
New York
.
[112]
Brisson-Noel
A.
Arthur
M.
Courvalin
P.
(
1988
)
Evidence for natural gene transfer from gram-positive cocci to Escherichia coli
J. Bacteriol.
 ,
170
,
1739
1745
.
[113]
Bertram
J.
Stratz
M.
Durre
P.
(
1991
)
Natural transfer of conjugative transposon Tn916 between Gram-positive and Gram-negative bacteria
J. Bacteriol.
 ,
173
,
443
448
.
[114]
Pang
Y.
Brown
B.A.
Steingrube
V.A.
Wallace
R.J.
Jr.
Roberts
M.C.
(
1994
)
Acquisition of gram-positive tetracycline resistance genes in Mycobacterium and Streptomyces species
Antimicrob. Agents Chemother.
 ,
38
,
1408
1412
.
[115]
Roberts
M.C.
Kenny
G.E.
(
1986
)
Dissemination of the tetM tetracycline resistance determinant to Ureaplasma urealyticum
Antimicrob. Agents Chemother.
 ,
29
,
350
352
.
[116]
Roberts
M.C.
Hillier
S.L.
Hale
J.
Holmes
K.K.
Kenny
G.E.
(
1986
)
Tetracycline resistance and tetM in pathogenic urogenital bacteria
Antimicrob. Agents Chemother.
 ,
30
,
810
812
.
[117]
Horaud
T.
de Cerspedes
G.
Clermont
D.
David
F.
Delbos
F.
(
1991
)
Variability of chromosomal genetic elements in streptoccoci
In:
Genetics and Molecular Biology of Streptococci, Lactococci and Enterococci
 
Dunny
GM.
Cleary
P.P.
McKay
L.L.
, Eds) pp
16
20
American Society for Microbiology
,
Washington DC
.
[118]
Charpentier
E.
Gerbaud
G.
Courvalin
P.
(
1994
)
Presence of the Listeria tetracycline resistance gene tet(S) in Enterococcus faecalis
Antimicrob. Agents Chemother.
 ,
38
,
2330
2335
.
[119]
Roberts
M.C.
McFarland
L.V.
Mullany
P.
Mulligan
M.E.
(
1994
)
Characterization of the genetic basis of antibiotic resistance in Clostridium difficile
J. Antimicrob. Chemother.
 ,
33
,
419
429
.
[120]
Nelson
M.L.
Park
B.H.
Andrew
J.S.
Georgian
V.A.
Thomas
B.C.
Levy
S.B.
(
1993
)
Inhibition of the tetracycline efflux antiport protein by 13-thio-substituted 5-hydroxy-6-deoxytetracyclines
J. Med. Chem.
 ,
36
,
370
377
.
[121]
Tymiak
A.A.
Aklonis
C.
Bolgar
M.S.
Kahle
A.D.
Kirsch
D.R.
O’Sullivan
J.
Porubcan
M.A.
Principe
P.
Trejo
W.H.
Ax
H.A.
Wells
J.S.
Andersen
H.H.
Devasthale
P.V.
Telikepalli
H.
van der Velde
D.
Zou
J.-Y.
Mitscher
L.A.
(
1993
)
Novel tetracycline glycosides active against tetracycline-resistant bacteria
J. Org. Chem.
 ,
58
,
535
537
.
[122]
Cohen
M.L.
(
1992
)
Epidemiology of drug resistance: implications for a post-antimicrobial era
Science
 ,
257
,
1050
1055
.
[123]
McCaig
L.F.
Hughes
J.M.
(
1995
)
Trends in antimicrobial drug prescribing among office-based physicians in the United States
JAMA
 ,
273
,
214
219
.
[124]
Nelson
W.L.
Kuritsky
J.N.
Kennedy
D.L.
Lao
C.S.
(
1987
)
Outpatient (outpt) pediatric antibiotic use in the US: trends and therapy for otitis media (OM) 1977–1986
, In:
Program and Abstracts of the 27th Interscience Conference on Antimicrobial Agents and Chemotherapy
  pp
175
American Society for Microbiology
,
Washington, DC
Abstract 455.
[125]
Report of the ASM Task Force on Antibiotic Resistance
 
1995
, American Society for Microbiology Supplement to Antimicrob. Agents Chemothe,
1
23
.
[126]
Lacroix
J.-M.
Walker
C.B.
(
1993
)
Detection and incidence of the tetracycline resistance determinant tet(M) in the microflora associated with adult periodontitis
J. Period.
 ,
66
,
102
108
.
[127]
Roberts
M.C.
Kenny
G.E.
(
1987
)
Conjugal transfer of transposon Tn916 from Streptococcus faecalis to Mycoplasma hominis
J. Bacteriol.
 ,
169
,
3836
3839
.
[128]
Roberts
M.C.
Leonard
R.B.
Briselden
A.M.
Schoenknecht
F.D.
Coyle
M.B.
(
1992
)
Characterization of antibiotic resistant Corynebacterium striatum strains
J. Antimicrob. Chemother.
 ,
30
,
463
474
.
[129]
Buu-Hoi
A.
Le Bouguenec
C.
Horaud
T.
(
1989
)
Genetic basis of antibiotic resistance in Aerococcus viridans
Antimicrob. Agents Chemother.
 ,
33
,
529
534
.
[30]
Fletcher
H.M.
Daneo-Moore
L.
(
1992
)
A truncated Tn916-like element in a clinical isolates of Enterococcus faecium
Plasmid
 ,
27
,
155
160
.
[131]
Roberts
M.C.
Chung
W.
Roe
D.E.
(
1996
)
Characterization of tetracycline and erythromycin determinants in Treponema denticola
Antimicrob. Agents Chemother.
 ,
40
,
1690
1694
.