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Related Experiment Videos

Current perspectives on glycopeptide resistance

N Woodford1, A P Johnson, D Morrison

  • 1Antibiotic Reference Unit, Central Public Health Laboratory, London, England.

Clinical Microbiology Reviews
|October 1, 1995
PubMed
Summary
This summary is machine-generated.

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Glycopeptide resistance in gram-positive bacteria is increasing due to altered antibiotic targets. Detecting this resistance is challenging, complicating treatment for hospital-acquired infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Increasing prevalence of gram-positive bacteria resistant to glycopeptide antibiotics in clinical settings over the past five years.
  • Resistance mechanisms often involve alterations in the peptidoglycan precursor target site, specifically the D-alanyl-D-alanine moiety.
  • Glycopeptide-resistant enterococci (GRE) pose a significant hospital-acquired infection challenge, with evidence of interpatient spread.

Purpose of the Study:

  • To highlight the growing issue of glycopeptide resistance in clinical gram-positive bacteria.
  • To discuss the challenges in reliably detecting low-level glycopeptide resistance.
  • To underscore the therapeutic difficulties associated with infections caused by these resistant pathogens.

Main Methods:

Related Experiment Videos

  • Review of clinical observations and resistance mechanisms.
  • Discussion of diagnostic challenges and criteria for resistance detection.
  • Analysis of dissemination factors in hospital environments.

Main Results:

  • Resistance is frequently linked to modifications of the D-alanyl-D-alanine target site.
  • Detection of low-level resistance is method-dependent and problematic.
  • Molecular typing implicates patient colonization, staff carriage, and environmental contamination in GRE spread.
  • Co-resistance to other antibiotics complicates treatment choices.

Conclusions:

  • Glycopeptide resistance in gram-positive bacteria, particularly enterococci, is a growing clinical concern.
  • Accurate and reliable detection methods for glycopeptide resistance are crucial.
  • Effective antimicrobial strategies are urgently needed to manage infections caused by these increasingly untreatable bacteria.