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Pristinamycin (INN), also spelled pristinamycine, is an antibiotic used primarily in the treatment of staphylococcal infections, and to a lesser extent streptococcal infections. It is a streptogramin group antibiotic, similar to virginiamycin, derived from the bacterium Streptomyces pristinaespiralis. It is marketed in Europe by Sanofi-Aventis under the trade name Pyostacine.

Pristinamycin is a mixture of two components that have a synergistic antibacterial action. Pristinamycin IA is a macrolide, and results in pristinamycin's having a similar spectrum of action to erythromycin. Pristinamycin IIA (streptogramin A) is a depsipeptide.^[1] PI and PII are coproduced by S. pristinaespiralis in a ratio of 30:70. Each compound binds to the bacterial 50 S ribosomal subunit and inhibits the elongation process of the protein synthesis, thereby exhibiting only a moderate bacteriostatic activity. However, the combination of both substances acts synergistically and leads to a potent bactericidal activity that can reach up to 100 times that of the separate components.

The pristinamycin biosynthetic gene cluster is the largest antibiotic supercluster known so far, with a size of ~210 kb, wherein the PI and PII biosynthetic genes are not clustered individually but are scattered across the complete sequence region.^[2] Furthermore, this biosynthetic gene region is interrupted by a cryptic type II PKS gene cluster.

Clinical use

Despite the macrolide component, it is effective against erythromycin-resistant staphylococci and strepcococci.^[3]^[4] It is active against methicillin-resistant Staphylococcus aureus (MRSA). Its usefulness for severe infections, however, may be limited by the lack of an intravenous formulation owing to its poor solubility.^[5] Nevertheless it is sometimes used as an alternative to rifampicin+fusidic acid or linezolid for the treatment of MRSA.

The lack of an intravenous formulation led to the development of the pristinamycin-derivative quinupristin/dalfopristin (i.e., Synercid), which may be administered intravenously for more severe MRSA infections.

Footnotes

^ Hamilton-Miller J (1991). "From foreign pharmacopoeias: 'new' antibiotics from old?". J Antimicrob Chemother 27 (6): 702–5. doi:10.1093/jac/27.6.702. PMID 1938680.
^ Mast Y, Weber T, Gölz M, Ort-Winklbauer R, Gondran A, Wohlleben W, Schinko E (2010) Characterization of the ‘pristinamycin supercluster’ of Streptomyces pristinaespiralis. Microbial Biotechnology. doi:10.1111/j.1751-7915.2010.00213.x
^ Weber P (2001). "[Streptococcus pneumoniae: lack of emergence of pristinamycin resistance]". Pathol Biol (Paris) 49 (10): 840–5. doi:10.1016/S0369-8114(01)00255-3. PMID 11776696.
^ Leclercq R, Soussy C, Weber P, Moniot-Ville N, Dib C (2003). "[In vitro activity of the pristinamycin against the isolated staphylococci in the french hospitals in 1999-2000]". Pathol Biol (Paris) 51 (7): 400–4. doi:10.1016/S0369-8114(03)00054-3. PMID 12948760.
^ Edited by Sean C. Sweetman, ed. (November 30, 2004). Martindale: The complete drug reference (34th ed.). London: Pharmaceutical Press. ISBN 0-85369-550-4.

UpToDate Contents

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1. 急性汎発性発疹性膿疱症（AGEP） acute generalized exanthematous pustulosis agep

English Journal

[Skin rash mimicking pityriasis rosea Gibert secondary to pristinamycin therapy].

Schmutz JL1, Trechot P2.
Annales de dermatologie et de vénéréologie.Ann Dermatol Venereol.2014 Apr;141(4):325-6. doi: 10.1016/j.annder.2014.01.001. Epub 2014 Feb 7.
PMID 24703654

Characterization of sal(A), a novel gene responsible for lincosamide and streptogramin A resistance in Staphylococcus sciuri.

Hot C1, Berthet N, Chesneau O.Author information 1Institut Pasteur, Unité des Membranes Bactériennes, Paris, France.AbstractNatural resistance to lincosamides and streptogramins A, which is a species characteristic of Bacillus subtilis and Enterococcus faecalis, has never been documented in the Staphylococcus genus. We have investigated here the molecular basis of the LSA phenotype exhibited by seven reference strains of Staphylococcus sciuri, including the type strains of the three described subspecies. By whole genome sequencing of strain ATCC 29059, we identified a candidate gene that would encode an ATP-binding cassette protein similar to Lsa and VmlR resistance determinants. Isolation and qRT-PCR expression studies confirmed that Sal(A) can confer a moderate resistance to lincosamides (x8 MIC of lincomycin) and a high-level resistance to streptogramins A (x64 MIC of pristinamycin II). The chromosomal location of sal(A) between two housekeeping genes of the staphylococcal core genome would support ancient origins and thus innate resistance to these antimicrobials within S. sciuri subspecies.
Antimicrobial agents and chemotherapy.Antimicrob Agents Chemother.2014 Mar 31. [Epub ahead of print]
Natural resistance to lincosamides and streptogramins A, which is a species characteristic of Bacillus subtilis and Enterococcus faecalis, has never been documented in the Staphylococcus genus. We have investigated here the molecular basis of the LSA phenotype exhibited by seven reference strains of
PMID 24687494

Ureaplasma urealyticum and Ureaplasma parvum in women of reproductive age.

Hunjak B1, Sabol I, Vojnović G, Fistonić I, Erceg AB, Peršić Z, Grce M.Author information 1Department of Microbiology and Bacteriology, Croatian National Institute of Public Health, Rockefellerova 2, 10000, Zagreb, Croatia.AbstractOBJECTIVES: To determine the incidence of Ureaplasma urealyticum and Ureaplasma parvum (UP) in symptomatic and asymptomatic women of reproductive age and to estimate antibiotic susceptibility of ureaplasma isolates.
Archives of gynecology and obstetrics.Arch Gynecol Obstet.2014 Feb;289(2):407-12. doi: 10.1007/s00404-013-2980-z. Epub 2013 Aug 4.
OBJECTIVES: To determine the incidence of Ureaplasma urealyticum and Ureaplasma parvum (UP) in symptomatic and asymptomatic women of reproductive age and to estimate antibiotic susceptibility of ureaplasma isolates.MATERIALS AND METHODS: This study included 424 ureaplasma positive women of 1,370 tes
PMID 23912532

Japanese Journal

バージニアマイシン添加飼料を給与した採卵鶏雛の耐性菌出現調査

飼料研究報告 26, 106-116, 2001-04
NAID 40004438134

A transcriptional regulator of a pristinamycin resistance gene in Streptomyces coelicolor

J. Biol. Chem. 276, 2001
NAID 30016330400

Design of a Novel Mammalian Screening System for the Detection of Bioavailable, Non-cytotoxic Streptogramin Antibiotics.

The Journal of Antibiotics 54(1), 44-55, 2001
NAID 130003503809

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★リンクテーブル★

リンク元	「プリスチナマイシン」

「プリスチナマイシン」

Pristinamycin
Combination of
Pristinamycin IA	antibiotic
Pristinamycin IIA	antibiotic
Clinical data
AHFS/Drugs.com	International Drug Names
MedlinePlus	a603007
Identifiers
CAS Number	270076-60-3
ATC code	J01FG01
PubChem	CID 11979535
ChemSpider	10152812
ChEMBL	CHEMBL1256399
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英: pristinamycin
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http://en.wikipedia.org/wiki/Pristinamycin

[Hamilton-Miller1991-1] Hamilton-Miller J (1991). "From foreign pharmacopoeias: 'new' antibiotics from old?". J Antimicrob Chemother 27 (6): 702–5. doi:10.1093/jac/27.6.702. PMID 1938680.

[2] Mast Y, Weber T, Gölz M, Ort-Winklbauer R, Gondran A, Wohlleben W, Schinko E (2010) Characterization of the ‘pristinamycin supercluster’ of Streptomyces pristinaespiralis. Microbial Biotechnology. doi:10.1111/j.1751-7915.2010.00213.x

[Weber2001-3] Weber P (2001). "[Streptococcus pneumoniae: lack of emergence of pristinamycin resistance]". Pathol Biol (Paris) 49 (10): 840–5. doi:10.1016/S0369-8114(01)00255-3. PMID 11776696.

[Leclercq2003-4] Leclercq R, Soussy C, Weber P, Moniot-Ville N, Dib C (2003). "[In vitro activity of the pristinamycin against the isolated staphylococci in the french hospitals in 1999-2000]". Pathol Biol (Paris) 51 (7): 400–4. doi:10.1016/S0369-8114(03)00054-3. PMID 12948760.

[Martindale34-5] Edited by Sean C. Sweetman, ed. (November 30, 2004). Martindale: The complete drug reference (34th ed.). London: Pharmaceutical Press. ISBN 0-85369-550-4.

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pristinamycin