Antimicrobial resistance in staphylococci. Epidemiology, molecular mechanisms, and clinical relevance

Infect Dis Clin North Am. 1997 Dec;11(4):813-49. doi: 10.1016/s0891-5520(05)70392-5.

Abstract

Staphylococcal infections continue to pose important clinical problems in children and adults. Antibiotic resistance among the staphylococci has rendered therapy of these infections a therapeutic challenge. Despite early, uniform susceptibility to penicillin, staphylococci acquired a gene elaborating beta-lactamase that rendered penicillin inactive and that is borne by nearly all clinical isolates. "Penicillinase-resistant beta-lactams," such as methicillin, were introduced in the early 1960s, but resistance to them has become an increasing concern. The mechanism of the so-called "methicillin resistance" is complex. Moreover, once confined to the ecology of hospitals and other institutions, a recent increase in community-acquired methicillin-resistant S. aureus infections has been observed. Glycopeptides, until now the only uniformly reliable therapeutic modality, have been increasingly used for therapy of staphylococcal infections. The recent recognition of clinical isolates with reduced susceptibility to glycopeptides is of concern.

Publication types

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

MeSH terms

  • Anti-Bacterial Agents / history
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Microbial*
  • History, 20th Century
  • Humans
  • Methicillin Resistance
  • Penicillin Resistance
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / history
  • Staphylococcus / drug effects
  • Staphylococcus / genetics
  • beta-Lactam Resistance

Substances

  • Anti-Bacterial Agents