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Update on vancomycin resistance.

B Perichon1, P Courvalin

  • 1Unité des Agents Antibactériens, Pasteur Institute, Paris, France.

International Journal of Clinical Practice
|July 27, 2000
PubMed
Summary
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Enterococci cause severe infections and are a major source of nosocomial infections. Antibiotic resistance, including to glycopeptides like vancomycin, is a growing concern due to modified cell wall precursors.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Enterococci are significant pathogens causing severe infections like endocarditis, meningitis, and septicaemia.
  • They are a leading cause of hospital-acquired (nosocomial) infections.
  • Antibiotic resistance in enterococci is a critical issue, particularly resistance to glycopeptides since 1986.

Purpose of the Study:

  • To review the mechanisms and types of glycopeptide resistance in enterococci.
  • To discuss the origins of glycopeptide resistance in these bacteria.
  • To highlight the clinical implications of vancomycin and teicoplanin resistance.

Main Methods:

  • Literature review of studies on enterococcal resistance mechanisms.
  • Analysis of biochemical pathways involved in peptidoglycan synthesis.

Related Experiment Videos

  • Examination of data on glycopeptide resistance types and origins.

    • Main Results:

    • Glycopeptide resistance in enterococci involves altered peptidoglycan precursors, blocking antibiotic action.
    • Five distinct types of glycopeptide resistance and their biochemical mechanisms are identified.
    • Enterococcal strains can exhibit resistance to vancomycin and teicoplanin, or vancomycin alone.
    • Vancomycin-dependent enterococcal strains have been isolated from clinical settings.
    • Resistance may originate from intrinsic resistance in enterococci or glycopeptide-producing organisms.

    Conclusions:

    • Glycopeptide resistance in enterococci poses a significant threat due to diverse resistance mechanisms.
    • Understanding these mechanisms is crucial for developing effective treatment strategies.
    • The emergence of vancomycin-dependent strains warrants further investigation and clinical vigilance.