Glycopeptide Resistance in Enterococci

Int Microbiol. 2000 Jun;3(2):71-80.

Abstract

The selective pressure resulting from the extensive use of antibiotics over the last 50 years has led to the emergence of bacterial resistance and to the dissemination of resistance genes among pathogenic microorganisms. Consequently, we are now at serious risk of suffering intractable, life-threatening infections. The progressive emergence and rapid dissemination of resistance to glycopeptides, the last resort for treating nosocomial infections with enterococci resistant to usual antibiotics, constitute one of the most dramatic examples of such resistance. Enterococci are normal human commensals, but are also a frequent cause of nosocomial urinary tract infections and nosocomial bacteremia. Enterococcus faecalis causes 80 to 90% of human enterococcal infections, while Enterococcus faecium accounts for most of the remainder. During the last decade, our understanding of the genetics and biochemical basis of resistance to glycopeptides has increased greatly. Furthermore, the application of molecular methods for the diagnosis of glycopeptide-resistant enterococci has provided new insights into the epidemiology of enterococcal infections.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Cell Wall / drug effects
  • Drug Resistance, Microbial* / genetics
  • Drug Synergism
  • Drug Utilization
  • Enterococcus / drug effects*
  • Enterococcus / genetics
  • Glycopeptides
  • Gram-Positive Bacteria / chemistry
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Operon
  • Peptidoglycan / chemistry
  • Polymerase Chain Reaction
  • Polymorphism, Restriction Fragment Length
  • Teicoplanin / chemistry
  • Teicoplanin / pharmacology
  • Vancomycin / chemistry
  • Vancomycin / pharmacology
  • Vancomycin Resistance / genetics

Substances

  • Anti-Bacterial Agents
  • Glycopeptides
  • Peptidoglycan
  • Teicoplanin
  • Vancomycin
  • avoparcin