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In streptococci  mef (I) and  catQ , two relatively uncommon macrolide and chloramphenicol resistance genes, respectively, are typically linked in a genetic module designated IQ module. Though variable, the module consistently encompasses, and is sometimes reduced to, a conserved ∼5.8-kb  mef (I)- catQ  fragment. The prototype IQ module was described in  Streptococcus pneumoniae . IQ-like modules have subsequently been detected in  Streptococcus pyogenes  and in different species of viridans group streptococci, where  mef (E) may be found instead of  mef (I). Three genetic elements, one carrying the prototype IQ module from  S. pneumoniae  and two carrying different, defective IQ modules from  S. pyogenes , have recently been characterized. All are integrative and conjugative elements (ICEs) belonging to the Tn 5253  family, and have been designated ICE Spn 529IQ, ICE Spy 029IQ and ICE Spy 005IQ, respectively. ICE Spy 029IQ and ICE Spy 005IQ were the first Tn 5253  family ICEs to be described in  S. pyogenes . A wealth of new information has been obtained by comparing their genetic organization, chromosomal integration, and transferability. The origin of the IQ module is unknown. The mechanism by which it spreads in streptococci is discussed.

Genetic basis of the association of resistance genes mef(I) (macrolides) and catQ (chloramphenicol) in streptococci