title: Mechanisms and implications of glycopeptide resistance in enterococci.
abstract: Glycopeptide resistance is recent in enterococci and its expression is inducible by glycopeptides. Two phenotypes can be distinguished: (a) resistance to high levels of vancomycin and teicoplanin, and (b) resistance to low levels of vancomycin only. There is no cross-resistance between glycopeptides, glycolipodepsipeptides (ramoplanin), and lipopeptides (daptomycin). The determinants conferring low-level resistance are nontransferable and presumably chromosomal. High-level resistance is plasmid-mediated and the plasmids range from 34 to 40 kb, are self-transferable, and encode various resistance combinations. All plasmids share the same glycopeptide resistance determinant, which is distinct from that conferring low-level resistance. Induction of resistance is associated with induction of about a 40 kDa protein. We have determined the sequence of the vanA gene encoding one such resistance protein designated VANA. Amino acid sequence similarity was detected between VANA and D-Ala: D-Ala ligases from Enterobacteriaceae. Complementation analysis in Escherichia coli indicated that VANA possesses D-Ala: D-Ala ligase activity and is therefore related to enzymes that catalyze synthesis of glycopeptide target, i.e., terminal D-Ala-D-Ala of peptidoglycan precursors. The contribution of VANA to synthesis of peptidoglycan in the presence of glycopeptides is unknown: VANA could bind to D-Ala-D-Ala, preventing the binding of the drugs; could modify the target of the drug; and could be a ligase with novel specificity.
authors.affiliation: Unité des Agents Antibactériens, Institut Pasteur, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Derlot
authors.forename: P
authors.initials: P
authors.lastname: Courvalin
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017576:Daptomycin; D047630:Depsipeptides; D004352:Drug Resistance, Microbial / Q000235:genetics; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics; D006020:Glycopeptides / Q000494:pharmacology*; D010455:Peptides / Q000494:pharmacology; D010456:Peptides, Cyclic; D017334:Teicoplanin; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D047630:Depsipeptides; D006020:Glycopeptides; D010455:Peptides; D010456:Peptides, Cyclic; C041438:ramoplanin; D017334:Teicoplanin; D014640:Vancomycin; D017576:Daptomycin