“…7 ). In addition, gene mutations identified in this study included many stringent response elements, and most of them were previously reported to be associated with conversion of hetero- to homo-resistance against β-lactam, such as genes associated with RNA polymerase (RNAP; rpoB 31 , 53 and rpoC 31 , 54 ), purine biosynthesis ( guaA 31 , prs 31 , 33 , hprT 31 , 33 , (p)ppGpp synthesis ( rel Sau 31 , 33 , 47 ), glycolysis ( pykA 31 , fbaA 31 , and fruB 33 ) protein quality control ( ftsH 31 , clpX 30 , 55 , and clpP 30 , 55 ), and tRNA synthase ( lysS 31 , and gltX 31 ). These results suggest that stringent-like response played an important role in β-lactam resistance in the oxacillin-resistant mutants of OS-MRSA.…”