Resistance or decreased susceptibility to glycopeptides, daptomycin, and linezolid in methicillin-resistant Staphylococcus aureus

Curr Opin Pharmacol. 2010 Oct;10(5):516-21. doi: 10.1016/j.coph.2010.06.006. Epub 2010 Jul 1.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) with decreased susceptibility to glycopeptides can be categorized as first, heteroresistant to vancomycin (hVISA); second, with intermediate susceptibility to vancomycin (VISA); and third, fully resistant to vancomycin (VRSA). Whereas the hVISA and VISA isolates are characterized by increased cell wall thickness, activated cell wall synthesis and reduced autolysis, VRSA harbor the vanA gene cluster resulting in a remodeled peptidoglycan. Nonsusceptibility to daptomycin has been associated with changes in the structure and function of the cell envelope and surface charge. Linezolid resistance in MRSA is often associated with mutations in the 23S rRNA, although resistance mediated by an acquired gene (cfr encoding a 23S rRNA methyltransferase) has now been documented in several continents and in outbreak settings.

Publication types

  • Review

MeSH terms

  • Acetamides / pharmacology
  • Acetamides / therapeutic use
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Daptomycin / pharmacology
  • Daptomycin / therapeutic use
  • Drug Resistance, Bacterial*
  • Glycopeptides / pharmacology
  • Glycopeptides / therapeutic use
  • Humans
  • Linezolid
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Oxazolidinones / pharmacology
  • Oxazolidinones / therapeutic use
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Glycopeptides
  • Oxazolidinones
  • Linezolid
  • Daptomycin