**10. Macrolides**

Macrolide resistance is common among *Abiotrophia* and *Granulicatella species* (49.2% of all isolates sensitive to erythromycin vs. 87% of all isolates sensitive to Clindamycin) [62]. Resistance mechanisms include efflux among *mef*(A) positive isolates and *erm*(B) gene causing resistance to both Erythomycin and Clindamycin [64]. It was shown that *erm*(B) gene is located on Tn916-related transposon in *A. defectiva* similar to the pneumococcal transposon Tn3872, enabling Abiotrophia to act as a donor and recipient of antibiotic resistance [72]. Macrolide resistance pattern of NVS is suggestive of constitutive macrolide-lincosamide-streptogramin B (cMLSB) phenotype. Zheng et al. noted that all three isolates of NVS that carried erm(B) (*G. adiacens* and *G. elegans*) also carried *tet*(M), tetracycline resistance gene which is carried on the same transposon as ermB gene [62, 64].
