A plasmid determining resistance to erythromycin, lincomycin, and vernamycin Ba was isolated from a strain of Streptococcus pyogenes. The plasmid has a molecular weight of approximately 17 x 108 and is present to the extent of one to two copies per chromosomal genome equivalent.Erythromycin and lincomycin are antibiotics used in the treatment of group A beta-hemolytic streptococcus (Streptococcus pyogenes) infections in patients for whom penicillin is contraindicated. S. pyogenes strains are usually susceptible to these agents, although resistant clinical isolates have been reported (7,8,10,12,13,15). Whether resistance in this species is related to extrachromosomal (plasmid) determinants, as is often the case among drug-resistant staphylococci and enteric bacilli, has, to our knowledge, not been reported. In this communication we report on the isolation and characterization of a plasmid from a clinical isolate of S. pyogenes and show that it determines resistance to erythromycin, lincomycin, and vernamycin Ba (a streptogramin B-type antibiotic).S. pyogenes strain 10535/72 (designated here as AC-1), serotype M22: T12, was originally isolated by J. Dixon in Alberta, Canada. This strain, which was isolated from the inflamed throat of a 17-year-old Cree Indian woman, is resistant to erythromycin and lincomycin (greater than 1 mg/ml in each case), as well as vernamycin B, (no zone of inhibition with susceptibility disks containing 20 ug of drug). The patient had not been treated with antibiotics during the previous 12 months but had been in recent contact with a member of her family who was on erythromycin therapy.Todd-Hewitt broth (THB; Difco) was used as a growth medium in both liquid and agar forms. Cell growth (at 37 C) was followed by measuring turbidity with a Klett-Summerson colorimeter.Materials and methods of plasmid analyses by dye-buoyant density and sucrose density centrifugation were as described in detail previously (3, 4), as were the methods of plasmid elimination with intercalating dyes ("curing") and electron microscopy analysis (5). Extraction of deoxyribonucleic acid (DNA) was performed as follows. A 200-ml log phase culture isotopically labeled with 1 mCi of [methyl-PH]-thymidine (22 Ci/mmol from Amersham/Searle) was washed with 15 ml of 0.03 M tris(hydroxymethyl)aminomethane-0.005 M Na2 ethylenediaminetetraacetic acid (EDTA)-0.05 M NaCl, pH 8.0, (TES) and resuspended in 3.0 ml of 25% glucose (in TES). A 0.5-ml quantity of 0.25 M EDTA (pH 8.0) was added, followed by the addition of 1.0 ml of lysozyme (5 mg/ml in TES). The suspension was allowed to incubate for 3 h at 37 C, at which point 0.5 ml of Pronase (5 mg/ml in TES, preincubated at 37 C for 30 min) was added, followed by another 30-min period of incubation. The cells were then lysed by the addition of 2.0 ml of sodium dodecyl sulfate (a 2% solution in TES). NaClO, (from a 5 M solution) was added to make a final concentration of 1 M. The lysate was then twice extracted with an equal volume of TES-saturated phenolchloroform (2: 1). Two volum...