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Related Experiment Videos

Aminoglycoside resistance in enterococci.

J W Chow1

  • 1Infectious Disease Section, John D. Dingell Veterans Affairs Medical Center, Wayne State University School of Medicine, Detroit, MI 48201, USA. aa2563@wayne.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 15, 2000
PubMed
Summary

Emerging aminoglycoside resistance genes in enterococci necessitate updated laboratory testing. Development of novel aminoglycosides is crucial to overcome resistance and maintain synergistic treatment effectiveness.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • High-level aminoglycoside resistance in enterococci is primarily caused by aminoglycoside-modifying enzymes.
  • These enzymes inactivate aminoglycosides, negating the synergistic bactericidal effect when combined with cell wall-active agents.
  • Current laboratory screening relies on gentamicin and streptomycin susceptibility testing.

Purpose of the Study:

  • To evaluate the impact of newly identified aminoglycoside resistance genes (aph(2")-Ib, aph(2")-Ic, aph(2")-Id) on enterococcal susceptibility testing.
  • To highlight the need for modifications in current diagnostic approaches for aminoglycoside synergism.
  • To emphasize the requirement for developing new aminoglycosides effective against resistant enterococcal strains.

Main Methods:

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  • Review of current clinical microbiology laboratory practices for detecting aminoglycoside resistance in enterococci.
  • Analysis of the prevalence and impact of specific aminoglycoside resistance genes.
  • Assessment of the limitations of existing aminoglycosides against resistant enterococci.

Main Results:

  • The emergence of aph(2")-Ib, aph(2")-Ic, and aph(2")-Id genes poses a challenge to existing susceptibility testing methods.
  • Current screening methods may fail to accurately detect resistance mediated by these novel genes.
  • Existing aminoglycosides are vulnerable to modification by a broad spectrum of enzymes found in enterococci.

Conclusions:

  • Clinical microbiology laboratories must adapt their strategies for detecting aminoglycoside synergism in enterococci.
  • The increasing prevalence of these resistance genes necessitates a re-evaluation of diagnostic protocols.
  • Development of novel, potent aminoglycosides resistant to common modifying enzymes is essential for effective treatment of enterococcal infections.