Occurrence and mechanisms of glycopeptide resistance in gram-positive cocci.

摘要: Despite belief that the unique mechanism of glycopeptide action would preclude development resistance in susceptible organisms, clinical isolates enterococci and staphylococci resistant to these compounds have been described. Among enterococci, there are at least three types resistance. Type A (high-level) was described Enterococcus faecium E. faecalis. It is inducible mediated by elaboration and/or increased activity enzymes: a ligase, dehydrogenase, carboxypeptidase, which orchestrate production peptidoglycan precursors do not bind vancomycin. B (low-level) also carboxypeptidase and, possibly, protein detectable after incubation vancomycin whose function unknown. C associated with ligase constitutively produced, chromosomally encoded, gallinarum. staphylococci, coagulase-negative were obtained glycopeptides one coagulase-positive isolate teicoplanin but Additionally, prepared laboratory. They produce an approximately 39-kDa cytoplasmic protein, unknown, undergone extensive reorganization their cell surface. The era universal gram-positive susceptibility can be presumed over; testing must now accompany isolation enterococcus or staphylococcus importance.