A screening of more than 1,500 drug-resistant strains of revealed evolutionary patterns characteristic of positive selection for three alanine racemase (Alr) mutations. We investigated these mutations using molecular modeling, 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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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700341PMC
http://dx.doi.org/10.1128/AAC.01575-17DOI Listing

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