Role of Alanine Racemase Mutations in Mycobacterium tuberculosis d-Cycloserine Resistance.

Nakatani, Y; Opel-Reading, HK; Merker, M; Machado, D; Andres, S; Kumar, SS; Moradigaravand, D; Coll, FORCID logo; Perdigão, J; Portugal, I; +19 more...Schön, T; Nair, D; Devi, KU; Kohl, TA; Beckert, P; Clark, TGORCID logo; Maphalala, G; Khumalo, D; Diel, R; Klaos, K; Aung, HLORCID logo; Cook, GM; Parkhill, JORCID logo; Peacock, SJ; Swaminathan, S; Viveiros, M; Niemann, S; Krause, KL; Köser, CUORCID logo and (2017) Role of Alanine Racemase Mutations in Mycobacterium tuberculosis d-Cycloserine Resistance. Antimicrobial agents and chemotherapy, 61 (12). ISSN 0066-4804 DOI: 10.1128/AAC.01575-17
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A screening of more than 1,500 drug-resistant strains of Mycobacterium tuberculosis revealed evolutionary patterns characteristic of positive selection for three alanine racemase (Alr) mutations. We investigated these mutations using molecular modeling, in vitro MIC testing, as well as direct measurements of enzymatic activity, which demonstrated that these mutations likely confer resistance to d-cycloserine.


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