Aminoglycoside resistance in enterococci.
High-level aminoglycoside resistance in enterococci is mediated generally by aminoglycoside-modifying enzymes, which eliminate the synergistic bactericidal effect usually seen when a cell wall-active agent is combined with an aminoglycoside. Clinical microbiology laboratories currently screen for aminoglycoside resistance in enterococci by testing gentamicin and streptomycin susceptibility. If the recently detected aminoglycoside resistance genes, aph(2")-Ib, aph(2")-Ic, and aph(2")-Id, become more prevalent among clinical isolates, the approach for detecting susceptibility to aminoglycoside synergism in enterococci will require modification. More potent aminoglycosides need to be developed that will be resistant to modification by a broad spectrum of aminoglycoside-modifying enzymes present in enterococci.
Chow
J W
JW
Infectious Disease Section, John D. Dingell Veterans Affairs Medical Center, Wayne State University School of Medicine, Detroit, MI 48201, USA. aa2563@wayne.edu
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004352:Drug Resistance, Microbial / Q000235:genetics; D004357:Drug Synergism; D004359:Drug Therapy, Combination / Q000494:pharmacology; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics; D005839:Gentamicins / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans
D000900:Anti-Bacterial Agents; D005839:Gentamicins